Sample Record
Owner Lab
- CT HQ - Sacramento Asphalt Binder Laboratory
DIME Sample ID 2021-09-08-17
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215393 DEA: 021J5104 EFIS: 0220000086 |
|---|---|
| DIST-CO-RTE-PM | 02-LAS,MOD-139-57.0/66.635,0.0/0.1 |
| Award Date | 02/10/2021 |
| Closeout Date | 11/24/2021 |
| Work Description | PERFORM COLD IN-PLACE RECYCLING AND PLACE HOT MIX ASPHALT (TYPE A). |
| Location Description | LASSEN AND MODOC COUNTIES NEAR ADIN FROM 4.5 MILES SOUTH OF COUNTY ROAD A2 TO 0.1 MILE SOUTH OF ROUTE 299 |
| QA Service Level | 1 (Verified on 01/07/2021) |
Sample Information
| Sample Taken Date | 09/08/2021 | Sample Unique Key | 17 |
|---|---|---|---|
| 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 | 09/20/2021 |
| Sample type | Department Acceptance | A brief description of the sample | 58-34M |
| The quantity of what the sample constitutes | 1 can | From where was the sample collected | Source |
| First name of sampler or witnessed by | E | Last name of sampler or witnessed by | CHAVEZ |
| Title of sampler | MATLS | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | KLAMATH FALLS, OR | Transportation Laboratory (TL) Number | c848967 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Asphalt Binder | Performance Grade | PG 58-34 M |
|---|---|---|---|
| Modified | Yes | Lot number | |
| Sublot number | Tank number | ||
| Time of sample | HMA Supplier | CONTRACTOR HAT CREEK | |
| Certified Asphalt Supplier | Albina Asphalt - Klamath Falls Plant - Klamath Falls OR | Multigrade | No |
| Multigrade Type | Asphalt Binder Mix Number | Not set |
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. | |||