Sample Record

Owner Lab

  • CT HQ - Sacramento Asphalt Binder Laboratory

DIME Sample ID 2021-09-09-28

Project Information

Project IdentifiersProject ID: 215393
DEA: 021J5104
EFIS: 0220000086
DIST-CO-RTE-PM02-LAS,MOD-139-57.0/66.635,0.0/0.1
Award Date02/10/2021
Closeout Date11/24/2021
Work DescriptionPERFORM COLD IN-PLACE RECYCLING AND PLACE HOT MIX ASPHALT (TYPE A).
Location DescriptionLASSEN AND MODOC COUNTIES NEAR ADIN FROM 4.5 MILES SOUTH OF COUNTY ROAD A2 TO 0.1 MILE SOUTH OF ROUTE 299
QA Service Level1 (Verified on 01/07/2021)

Sample Information

Sample Taken Date09/09/2021 Sample Unique Key28
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 testing09/20/2021
Sample typeAcceptance A brief description of the sample58-34M
The quantity of what the sample constitutes1 can From where was the sample collectedSource
First name of sampler or witnessed byE Last name of sampler or witnessed byCHAVEZ
Title of samplerMATLS Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameKLAMATH FALLS, OR Transportation Laboratory (TL) Numberc848968
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Binder Performance GradePG 58-34 M
ModifiedYes Lot number
Sublot number Tank number
Time of sample HMA SupplierCONTRACTOR HAT CREEK
Asphalt Binder SupplierAlbina Asphalt - Klamath Falls Plant - Klamath Falls OR MultigradeNo
Multigrade Type HMA Design ID

Submitted Tests

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