Sample Record

Owner Lab

  • CT HQ - Sacramento Asphalt Binder Laboratory

DIME Sample ID 2021-06-29-28

Project Information

Project IdentifiersProject ID: 215075
DEA: 060Q9104
EFIS: 0614000005
DIST-CO-RTE-PM06-TUL-99-19.2/19.8
Award DateNot set
Closeout DateNot set
Work DescriptionBRIDGE DECK AND OUTSIDE GIRDER REPLACEMENT.
Location DescriptionTULARE COUNTY NEAR TIPTON FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF AVENUE 152 OVERCROSSING
QA Service Level1 (Verified on 07/28/2020)

Sample Information

Sample Taken Date06/29/2021 Sample Unique Key28
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 testing06/29/2021
Sample typeAcceptance A brief description of the samplePG70-10
The quantity of what the sample constitutes1 of 1 cans From where was the sample collectedManufacturer
First name of sampler or witnessed byB Last name of sampler or witnessed byLathan
Title of samplerLab tech Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameJaxon - Deer Creek Transportation Laboratory (TL) Numberc056229
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Binder Performance GradePG 70-10
ModifiedNo Lot number
Sublot number Tank number
Time of sample HMA SupplierJaxon - Deer Creek
Asphalt Binder SupplierSan Joaquin Refinery - Bakersfield CA MultigradeNo
Multigrade Type HMA Design ID

Submitted Tests

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