Sample Record

Owner Lab

  • CT HQ - Sacramento Asphalt Binder Laboratory

DIME Sample ID 2020-07-19-9

Project Information

Project IdentifiersProject ID: 213469
DEA: 024C40V4
EFIS: 0218000125
DIST-CO-RTE-PM02-SHA-5-R3.8/R11.7
Award Date11/06/2018
Closeout Date08/16/2023
Work DescriptionWIDEN TO 6 LANES, BRIDGE REPLACEMENT AND WIDENING AND ROADWAY REHAB
Location DescriptionSHASTA COUNTY IN AND NEAR ANDERSON FROM ROUTE 5/273 SEPARATION TO 0.4 MILE SOUTH OF CHURN CREEK ROAD OVERCROSSING
QA Service Level1 (Verified on 12/31/2018)

Sample Information

Sample Taken Date07/19/2020 Sample Unique Key9
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 testing07/30/2021
Sample typeAcceptance A brief description of the samplePG58-22
The quantity of what the sample constitutes1 of 1 can From where was the sample collectedManufacturer
First name of sampler or witnessed byJD Last name of sampler or witnessed byAtkinson
Title of samplerField Tech Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameJF Shea - Fawndale Transportation Laboratory (TL) Numberc858987
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 number1
Sublot number4 Tank number
Time of sample HMA SupplierJF Shea - Fawndale
Certified Asphalt SupplierValero Marketing & Supply - Benicia CA MultigradeNo
Multigrade Type Asphalt Binder Mix NumberNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Test File Attachments