Sample Record
Owner Lab
- CT D02 - North Region Materials Lab
DIME Sample ID 2021-11-02-28
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 215424 DEA: 024G4404 EFIS: 0214000013 |
|---|---|
| DIST-CO-RTE-PM | 02-SIS-3-38.0/38.6 |
| Award Date | 03/22/2021 |
| Closeout Date | Not set |
| Work Description | BRIDGE REPLACEMENT |
| Location Description | SISKIYOU COUNTY ABOUT 6 MILES NORTH OF FORT JONES FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF LOWER MOFFETT CREEK ROAD |
| QA Service Level | 1 (Verified on 01/19/2021) |
Sample Information
| Sample Taken Date | 11/02/2021 | Sample Unique Key | 28 |
|---|---|---|---|
| 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 testing | 11/02/2021 |
| Sample type | Acceptance | A brief description of the sample | Lime Treated 3/4-inch Type A HMA (eq. PG 64-28 M) with 22.0% RAP and virgin PG 58-34 M from Valero - Benicia |
| The quantity of what the sample constitutes | Production Start-Up Evaluation | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Clint | Last name of sampler or witnessed by | Rogers |
| Title of sampler | PI | Telephone number of sampler | |
| Laboratory sample identification | D78970 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Tullis - Northstate Asphalt - Redding, CA | Transportation Laboratory (TL) Number | 853085 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Hot Mix Asphalt | HMA Type | Type A HMA |
|---|---|---|---|
| HMA Grading | 3/4 inch | Lot number | Unknown |
| Sublot number | Unknown | HMA Design ID |