Sample Record
Owner Lab
- CT D03 - Olivehurst Northern Regional Laboratory
DIME Sample ID 2021-04-12-68
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215033 DEA: 033H6504 EFIS: 0318000027 |
|---|---|
| DIST-CO-RTE-PM | 03-NEV-49-8.3/8.7 |
| Award Date | 08/07/2020 |
| Closeout Date | 09/23/2021 |
| Work Description | CONSTRUCT A TWO-WAY LEFT-TURN LANE AND 8' SHOULDERS. |
| Location Description | NEVADA COUNTY ON ROUTE 49 FROM 0.1 MILE SOUTH OF ROUND VALLEY ROAD TO 0.1 MILE NORTH OF QUAIL CREEK DRIVE |
| QA Service Level | 1 (Verified on 06/22/2020) |
Sample Information
| Sample Taken Date | 04/12/2021 | Sample Unique Key | 68 |
|---|---|---|---|
| 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 | 04/13/2021 |
| Sample type | Verification | A brief description of the sample | PG 64-16 Asphalt Binder |
| The quantity of what the sample constitutes | 3 cans | From where was the sample collected | Distributor |
| First name of sampler or witnessed by | KRC Personnel (SAMPLER) | Last name of sampler or witnessed by | Thao Xiong (WITNESS) |
| Title of sampler | Unknown | Telephone number of sampler | Unknown |
| Laboratory sample identification | JMF21-022 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Knife River Construction - Hallwood | Transportation Laboratory (TL) Number | C779131 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Asphalt Binder | Performance Grade | PG 64-16 |
|---|---|---|---|
| Modified | Yes | Lot number | |
| Sublot number | Tank number | Unknown | |
| Time of sample | Unknown | HMA Supplier | Knife River Construction - Hallwood |
| Certified Asphalt Supplier | Valero Marketing & Supply - Benicia CA | Multigrade | No |
| Multigrade Type | Asphalt Binder Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2021-62 | Date Created | 06/21/2021 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-23-2021-79 | JMF Status | Submittal Authorized For Use |
| Producer Mix ID | HR-22771000V | Authorized Date | 09/10/2021 |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||