Sample Record

Owner Lab

  • CT HQ - Sacramento Asphalt Binder Laboratory

DIME Sample ID 2021-06-22-44

Project Information

Project IdentifiersProject ID: 215441
DEA: 021J5204
EFIS: 0220000087
DIST-CO-RTE-PM02-MOD,SIS-139-34.0/50.7,0.0/5.0
Award Date03/02/2021
Closeout Date09/27/2021
Work DescriptionPLACE ASPHALT RUBBER BINDER CHIP SEAL & REPLACE AC SURFACING.
Location DescriptionMODOC AND SISKIYOU COUNTIES AT AND NEAR NEWELL FROM 3.3 MILES NORTH OF PEREZ OVERHEAD TO ROUTE 161
QA Service Level1 (Verified on 02/01/2021)

Sample Information

Sample Taken Date06/22/2021 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 testing07/13/2021
Sample typeAcceptance A brief description of the sampleRubberized PG58-22
The quantity of what the sample constitutes1 of 2 gallon can From where was the sample collectedDistributor
First name of sampler or witnessed byJacob Last name of sampler or witnessed byS
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameAlbina - Klamath Falls Transportation Laboratory (TL) Number815585
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Rubber Binder Asphalt modifier supplier
Performance GradePG 58-22 Lot number
Sublot number HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.