Sample Record

Owner Lab

  • CT D03 - North Region Materials Lab

DIME Sample ID 2021-03-19-26

Project Information

Project IdentifiersProject ID: 215405
DEA: 032G1604
EFIS: 0320000235
DIST-CO-RTE-PM03-YOL-45-0.6/12.9
Award Date02/16/2021
Closeout Date06/30/2021
Work DescriptionCOLD PLANE AC PAVEMENT AND REPLACE WITH HOT MIX ASPHALT.
Location DescriptionYOLO COUNTY NEAR KNIGHTS LANDING FROM SYCAMORE SLOUGH BRIDGE TO YOLO COUNTY LINE ROAD
QA Service Level1 (Verified on 01/18/2021)

Sample Information

Sample Taken Date03/19/2021 Sample Unique Key26
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing03/19/2021
Sample typeVerification A brief description of the sampleAsphalt Binder PG 64-16
The quantity of what the sample constitutesJMF Verification From where was the sample collectedManufacturer
First name of sampler or witnessed byTeichert Personnel (SAMPLER) Last name of sampler or witnessed bySam Mosallem (WITNESS)
Title of sampler Telephone number of sampler
Laboratory sample identificationJMF21-015 Linked DIME Sample ID
The fabricator/manufacturer/facility nameTeichert - Woodland Plant Transportation Laboratory (TL) NumberC849138
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Binder Performance GradePG 64-16
ModifiedNo Lot number
Sublot number Tank number
Time of sample HMA SupplierTeichert - Woodland Plant
Asphalt Binder SupplierMarathon Petroleum Co. LP - Elk Grove CA MultigradeNo
Multigrade TypeNot set JMF Verification ID JMF3513-2021-51

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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