Sample Record
Owner Lab
- CT D04 - Hayward DME / District Laboratory
DIME Sample ID 2021-07-13-33
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215660 DEA: 040W3804 EFIS: 0420000211 |
|---|---|
| DIST-CO-RTE-PM | 04-SM-92-R9.5/R10.4 |
| Award Date | 05/18/2021 |
| Closeout Date | 05/26/2022 |
| Work Description | COLD PLANE AC PAVEMENT AND PLACE RHMA (G). |
| Location Description | SAN MATEO COUNTY IN SAN MATEO FROM 0.1 MILE EAST OF WEST HILLSDALE BOULEVARD UNDERCROSSING TO 0.1 MILE WEST OF ALAMEDA DE LAS PULGAS OVERCROSSING |
| QA Service Level | 1 (Verified on 05/03/2021) |
Sample Information
| Sample Taken Date | 07/13/2021 | Sample Unique Key | 33 |
|---|---|---|---|
| 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 | 08/26/2021 |
| Sample type | Verification | A brief description of the sample | 2 Cans of Asphalt Binder |
| The quantity of what the sample constitutes | 2 cans | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Tanh Ng | Last name of sampler or witnessed by | Ng |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Central Concrete Redwood City 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 | Peninsula Road Materials | |
| Certified Asphalt Supplier | Valero Marketing & Supply - Benicia CA | Multigrade | No |
| Multigrade Type | Asphalt Binder Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2021-69 | Date Created | 08/11/2021 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-318-2021-87 | JMF Status | Submittal Authorized For Use |
| Producer Mix ID | 937 | Authorized Date | 09/03/2021 |
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. | |||