Sample Record

Owner Lab

  • CT HQ - Sacramento Asphalt Binder Laboratory

DIME Sample ID 2021-09-28-41

Project Information

Project IdentifiersProject ID: 213469
DEA: 024C40V4
EFIS: 0218000125
DIST-CO-RTE-PM02-SHA-5-R3.8/R11.7
Award Date11/06/2018
Closeout DateNot set
Work DescriptionWIDEN TO 6 LANES, BRIDGE REPLACEMENT AND WIDENING AND ROADWAY REHAB
Location DescriptionSHASTA COUNTY IN AND NEAR ANDERSON FROM ROUTE 5/273 SEPARATION TO 0.4 MILE SOUTH OF CHURN CREEK ROAD OVERCROSSING
QA Service Level1 (Verified on 12/31/2018)

Sample Information

Sample Taken Date09/28/2021 Sample Unique Key41
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 testing10/13/2021
Sample typeAcceptance A brief description of the sampleNO TEST, PG 64-16
The quantity of what the sample constitutes2 cans From where was the sample collectedManufacturer
First name of sampler or witnessed byC Last name of sampler or witnessed byBryant
Title of samplerTET Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameJF Shea - Fawndale 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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