Sample Record

Owner Lab

  • CT D03 - Olivehurst Northern Regional Laboratory

DIME Sample ID 2021-04-01-41

Project Information

Project IdentifiersProject ID: 214426
DEA: 030A5704
EFIS: 0300020593
DIST-CO-RTE-PM03-YUB-20-13.3/R18.2
Award Date01/02/2020
Closeout DateNot set
Work DescriptionBrowns Valley Rehab: CONSTRUCT BRIDGE, REALIGN CURVE, WIDEN SHOULDERS AND CULVERT WORK.
Location DescriptionYUBA COUNTY FROM MARYSVILLE ROAD TO THE YUBA RIVER BRIDGE
QA Service Level1 (Verified on 10/23/2019)

Sample Information

Sample Taken Date04/01/2021 Sample Unique Key41
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 testing04/01/2021
Sample typeVerification A brief description of the samplePG 64-16 Marathon
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 by Brad McKeehan (WITNESS)
Title of samplerUnknown Telephone number of samplerUnknown
Laboratory sample identificationJMF21-020C Linked DIME Sample ID
The fabricator/manufacturer/facility nameTeichert - Hallwood Plant Transportation Laboratory (TL) NumberC706329
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 Supplier
Certified Asphalt SupplierMarathon Petroleum Co. LP - Elk Grove CA MultigradeNo
Multigrade TypeNot set Asphalt Binder 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