Sample Record

Owner Lab

  • CT HQ - Sacramento Asphalt Binder Laboratory

DIME Sample ID 2021-05-26-44

Project Information

Project IdentifiersProject ID: 215253
DEA: 021J4804
EFIS: 0220000083
DIST-CO-RTE-PM02-SHA,TRI-36-8.0/11.912,27.1/R41.139
Award Date02/05/2021
Closeout Date09/30/2021
Work DescriptionASPHALT RUBBER CHIP SEAL AND TRAFFIC STRIPE.
Location DescriptionSHASTA AND TRINITY COUNTIES AT AND NEAR PLATINA FROM 0.4 MILE EAST OF MIDDLE FORK COTTONWOOD CREEK BRIDGE TO BEEGUM CREEK BRIDGE AND FROM 1.3 MILES EAST OF BRAMLET ROAD TO SHASTA COUNTY LINE
QA Service Level1 (Verified on 10/30/2020)

Sample Information

Sample Taken Date05/26/2021 Sample Unique Key44
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 testing06/23/2021
Sample typeAcceptance A brief description of the samplePG58-22
The quantity of what the sample constitutes3RD NO TEST From where was the sample collectedSource
First name of sampler or witnessed byD. Last name of sampler or witnessed byOWENS
Title of samplerPEI Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameValero-Benicia Asphalt Plant Transportation Laboratory (TL) NumberNot Provided
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Binder Performance GradePG 58-22
ModifiedNo Lot number
Sublot number Tank number
Time of sample HMA Supplier
Asphalt Binder SupplierValero Marketing & Supply - Benicia CA MultigradeNo
Multigrade Type HMA Design ID

Submitted Tests

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