Sample Record

Owner Lab

  • Jaxon Enterprises - Deer Creek Rock & Asphalt

DIME Sample ID 2021-06-01-20

Project Information

Project IdentifiersProject ID: 66667
DEA: JMFPP
EFIS: 0019000043
DIST-CO-RTE-PM59---
Award DateNot set
Closeout DateNot set
Work DescriptionSpecial project for submitting Sample information for JMF Prequalification Program.
Location DescriptionNot set
QA Service LevelNOT VERIFIED

Sample Information

Sample Taken Date06/01/2021 Sample Unique Key20
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 testing06/01/2021
Sample typeQuality Control A brief description of the sampleRock dust
The quantity of what the sample constitutes6 bags From where was the sample collectedSource
First name of sampler or witnessed byJordan Last name of sampler or witnessed byBaker
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameDeer 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 TypeAggregate Source Identification (SMARA or name of Pit)91-54-0021::DEER CREEK ASPHALT
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 collectedat the plant from the stockpile
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Sizefine
The concrete mix design number Lot number
Sublot number HMA Design ID JMF3512-2021-74-21-1011.263-0.75inch-Lime

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-06-01-20-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)CGI Technician Jaxon Enterprises - Deer Creek Rock & Asphalt06/01/2021Jordan Baker
Yes
06/11/2021