Sample Record
Owner Lab
- CT HQ - Sacramento Asphalt Binder Laboratory
DIME Sample ID 2021-06-18-13
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 212777 DEA: 021H1104 EFIS: 0215000106 |
|---|---|
| DIST-CO-RTE-PM | 02-LAS-299-25.58/25.58 |
| Award Date | 12/04/2019 |
| Closeout Date | 08/14/2023 |
| Work Description | BUILDING WORK. |
| Location Description | LASSEN COUNTY ABOUT 11 MILES EAST OF BIEBER AT THE ADIN MAINTENANCE STATION |
| QA Service Level | 1 (Verified on 01/08/2019) |
Sample Information
| Sample Taken Date | 06/18/2021 | Sample Unique Key | 13 |
|---|---|---|---|
| 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 | 06/24/2021 |
| Sample type | Acceptance | A brief description of the sample | PG 64-28M |
| The quantity of what the sample constitutes | 2 cans | From where was the sample collected | Source |
| First name of sampler or witnessed by | E | Last name of sampler or witnessed by | C |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Albina - Klamath Falls, OR | Transportation Laboratory (TL) Number | c766445 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Asphalt Binder | Performance Grade | PG 64-28 M |
|---|---|---|---|
| Modified | Yes | Lot number | |
| Sublot number | Tank number | ||
| Time of sample | HMA Supplier | ||
| Certified Asphalt Supplier | Albina Asphalt - Klamath Falls Plant - Klamath Falls OR | Multigrade | No |
| Multigrade Type | Asphalt Binder Mix Number | Not set |
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. | |||