Sample Record

Owner Lab

  • CT HQ - Sacramento Asphalt Binder Laboratory

DIME Sample ID 2021-11-11-32

Project Information

Project IdentifiersProject ID: 44444
DEA: ASCP
EFIS: ASCP
DIST-CO-RTE-PM59---
Award DateNot set
Closeout DateNot set
Work DescriptionSpecial project for submitting Sample information for Asphalt Supplier Certification Program.
Location DescriptionNot set
QA Service LevelNOT VERIFIED

Sample Information

Sample Taken Date11/11/2021 Sample Unique Key32
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 testing12/17/2021
Sample typeVerification A brief description of the sample6
The quantity of what the sample constitutes1 of 3 From where was the sample collectedManufacturer
First name of sampler or witnessed byGabriela Last name of sampler or witnessed byDiaz
Title of sampler Telephone number of sampler
Laboratory sample identification111121-6 Linked DIME Sample ID
The fabricator/manufacturer/facility nameMojave, CA. Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Binder Performance GradePG 64-16
Modified Lot number
Sublot number Tank number
Time of sample HMA Supplier
Asphalt Binder SupplierWestern Emulsions - White City Emulsion Plant - White City OR MultigradeNo
Multigrade Type JMF Verification ID

Submitted Tests

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