Sample Record
Owner Lab
- CT D03 - Olivehurst Northern Regional Laboratory
DIME Sample ID 2021-06-04-20
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215626 DEA: 032G1504 EFIS: 0320000234 |
|---|---|
| DIST-CO-RTE-PM | 03-PLA-193-3.0/10.1 |
| Award Date | 05/11/2021 |
| Closeout Date | 11/29/2021 |
| Work Description | COLD PLANE AC PAVEMENT & RHMA OVERLAY. |
| Location Description | PLACER COUNTY NEAR LINCOLN FROM SIERRA COLLEGE BOULEVARD TO OPHIR ROAD |
| QA Service Level | 1 (Verified on 03/29/2021) |
Sample Information
| Sample Taken Date | 06/04/2021 | Sample Unique Key | 20 |
|---|---|---|---|
| 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 | 06/22/2021 |
| Sample type | Verification | A brief description of the sample | PG64-16 Asphalt Binder |
| The quantity of what the sample constitutes | 3 cans | From where was the sample collected | Supplier |
| First name of sampler or witnessed by | Mack | Last name of sampler or witnessed by | Abbott |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Teichart-Hallwood Drum Plant | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Asphalt Binder | Performance Grade | PG 64-16 |
|---|---|---|---|
| Modified | Lot number | ||
| Sublot number | Tank number | ||
| Time of sample | HMA Supplier | ||
| Certified Asphalt Supplier | Marathon Petroleum Co. LP - Elk Grove CA | Multigrade | No |
| Multigrade Type | Asphalt Binder Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2021-65 | Date Created | 08/03/2021 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-23-2021-83 | JMF Status | Submittal Authorized For Use |
| Producer Mix ID | 309-40542500-M | Authorized Date | 07/26/2021 |
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. | |||