Sample Record

Owner Lab

  • CT HQ - Hot Mix Asphalt Laboratory

DIME Sample ID 2021-04-19-41

Project Information

Project IdentifiersProject ID: 215179
DEA: 010F4704
EFIS: 0116000011
DIST-CO-RTE-PM01-HUM-299-30.7/37.7
Award Date11/19/2020
Closeout DateNot set
Work DescriptionPLACE HMA & RHMA-G & CONSTRUCT SOLDIER PILE WALL.
Location DescriptionHUMBOLDT COUNTY NEAR WILLOW CREEK AT VARIOUS LOCATIONS FROM 0.1 MILE EAST OF CEDAR CREEK ROAD TO 1.1 MILES WEST OF ROUTE 96 JUNCTION
QA Service Level1 (Verified on 09/15/2020)

Sample Information

Sample Taken Date04/19/2021 Sample Unique Key41
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 testing06/08/2021
Sample typeDispute Resolution A brief description of the sample3/4" HMA PG64-16 NO RAP
The quantity of what the sample constitutesboxes From where was the sample collectedManufacturer
First name of sampler or witnessed byna Last name of sampler or witnessed byna
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameMercer Fraser - Willow Creek 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 Grading3/4 inch Lot number
Sublot number HMA Design ID

Submitted Tests

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