Sample Record
Owner Lab
- CT D03 - Olivehurst Northern Regional Laboratory
DIME Sample ID 2021-09-20-66
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214700 DEA: 030F2804 EFIS: 0312000069 |
|---|---|
| DIST-CO-RTE-PM | 03-SAC-99-7.1/9.4 |
| Award Date | 01/21/2021 |
| Closeout Date | 08/21/2023 |
| Work Description | Dillard Overcrossing and McConnel Overhead |
| Location Description | Hwy 99, Elk Grove, CA |
| QA Service Level | 1 (Verified on 04/20/2020) |
Sample Information
| Sample Taken Date | 09/20/2021 | Sample Unique Key | 66 |
|---|---|---|---|
| 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 testing | 09/30/2021 |
| Sample type | Verification | A brief description of the sample | Asphalt Binder PG58-22(Valero) |
| The quantity of what the sample constitutes | Cans of Mix | From where was the sample collected | Supplier |
| First name of sampler or witnessed by | J | Last name of sampler or witnessed by | Cotten |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Valero-Benicia Asphalt Plant | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Asphalt Binder | Performance Grade | PG 58-22 |
|---|---|---|---|
| Modified | Lot number | ||
| Sublot number | Tank number | ||
| Time of sample | HMA Supplier | ||
| Certified Asphalt Supplier | Valero Marketing & Supply - Benicia CA | Multigrade | No |
| Multigrade Type | Asphalt Binder Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2021-86 | Date Created | 12/28/2021 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-23-2021-104 | JMF Status | Submittal Authorized For Use |
| Producer Mix ID | 1465 | Authorized Date | 10/18/2021 |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||