Sample Record
Owner Lab
- Jaxon Enterprises - Deer Creek Rock & Asphalt
DIME Sample ID 2021-06-01-19
Project Information
Project Identifiers | Project ID: 66667 DEA: JMFPP EFIS: 0019000043 |
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DIST-CO-RTE-PM | 59--- |
Award Date | Not set |
Closeout Date | Not set |
Work Description | Special project for submitting Sample information for JMF Prequalification Program. |
Location Description | Not set |
QA Service Level | NOT VERIFIED |
Sample Information
Sample Taken Date | 06/01/2021 | Sample Unique Key | 19 |
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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 testing | 06/01/2021 |
Sample type | Quality Control | A brief description of the sample | Washed Dust Untreated Aggregate |
The quantity of what the sample constitutes | 6 bags | From where was the sample collected | Source |
First name of sampler or witnessed by | Jordan | Last name of sampler or witnessed by | Baker |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | Deer Creek Rock and Asphalt | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-54-0021::DEER CREEK ASPHALT |
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The fabricator's/manufacturer's product name for the sample | The fabricator/manufacturer designation for the sample | ||
The plant number | A detailed description of where the material sample was collected | at the plant from the stockpile | |
Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | fine | |
The concrete mix design number | Lot number | ||
Sublot number | Aggregate Mix Number | Not set |
JMF Information
HMA Design ID | JMF3512-2021-74-21-1011.263-0.75inch-Lime | Date Created | 06/11/2021 |
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Submittal | N/A |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2021-06-01-19-1 AASHTO T27-14 (Verified)