Sample Record

Owner Lab

  • CT HQ - Sacramento Hot Mix Asphalt Laboratory

DIME Sample ID 2021-04-27-27

Project Information

Project IdentifiersProject ID: 214511
DEA: 010E0004
EFIS: 0113000091
DIST-CO-RTE-PM01-HUM-101-84.4/84.8
Award Date01/29/2020
Closeout DateNot set
Work DescriptionBRIDGE RAIL REPLACEMENT.
Location DescriptionHUMBOLDT COUNTY NEAR ARCATA FROM JACOBY CREEK BRIDGE TO GANNON SLOUGH BRIDGE
QA Service Level1 (Verified on 11/13/2019)

Sample Information

Sample Taken Date04/27/2021 Sample Unique Key27
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing05/25/2021
Sample typeDispute Resolution A brief description of the sample1/2" HMA NO RAP
The quantity of what the sample constitutes_ From where was the sample collectedManufacturer
First name of sampler or witnessed by_ Last name of sampler or witnessed by_
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameMercer Fraser - Fortuna Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeHot Mix Asphalt HMA TypeType A HMA
HMA Grading1/2 inch Lot number
Sublot number HMA Mix NumberNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments