Sample Record

Owner Lab

  • CT HQ - Sacramento Asphalt Binder Laboratory

DIME Sample ID 2021-09-21-50

Project Information

Project IdentifiersProject ID: 215414
DEA: 101J2104
EFIS: 1018000144
DIST-CO-RTE-PM10-SJ-99-9.4/15.0
Award Date02/23/2021
Closeout DateNot set
Work DescriptionPLACE RHMA, COLD PLANE ASPHALT CONCRETE, TRAFFIC STRIPING.
Location DescriptionSAN JOAQUIN COUNTY IN AND NEAR STOCKTON FROM 0.2 MILE NORTH OF LATHROP ROAD OVERCROSSING TO 0.3 MILE NORTH OF ARCH ROAD UNDERCROSSING
QA Service Level1 (Verified on 02/01/2021)

Sample Information

Sample Taken Date09/21/2021 Sample Unique Key50
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 testing10/07/2021
Sample typeAcceptance A brief description of the samplePG 64-16
The quantity of what the sample constitutes NO TEST 9/21, 9/20, 9/22, 9/26, 9/27, 9/28, 9/29, 9/30 From where was the sample collectedSupplier
First name of sampler or witnessed byJ Last name of sampler or witnessed byKort
Title of samplerInspector Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameTeichert Materials Vernalis Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Rubber Binder Asphalt modifier supplier
Performance GradePG 64-16 Lot number
Sublot number HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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