Sample Record
Owner Lab
- CT D03 - Olivehurst Northern Regional Laboratory
DIME Sample ID 2022-01-21-49
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Project Information
| Project Identifiers | Project ID: 993183 DEA: 031H2704 EFIS: 0316000082 |
|---|---|
| DIST-CO-RTE-PM | 03-YUB-70-R11.2/13.5 |
| Award Date | 10/14/2021 |
| Closeout Date | Not set |
| Work Description | UPGRADE BRIDGE RAILS & CONSTRUCT CONCRETE MEDIAN BARRIER. |
| Location Description | YUBA COUNTY NEAR LINDA AND MARYSVILLE FROM 2.4 MILES SOUTH OF FEATHER RIVER BOULEVARD UNDERCROSSING TO THE YUBA RIVER BRIDGE AND OVERHEAD |
| QA Service Level | 1 (Verified on 08/16/2021) |
Sample Information
| Sample Taken Date | 01/21/2022 | Sample Unique Key | 49 |
|---|---|---|---|
| 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 | 02/10/2022 |
| Sample type | Verification | A brief description of the sample | pg 64-16 PNW |
| The quantity of what the sample constitutes | 12 boxes of HMA, 2 cans of binder | From where was the sample collected | Supplier |
| First name of sampler or witnessed by | Zack | Last name of sampler or witnessed by | Mason |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | PNW | 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 64-16 |
|---|---|---|---|
| Modified | Lot number | ||
| Sublot number | Tank number | ||
| Time of sample | HMA Supplier | ||
| Certified Asphalt Supplier | Pacific Northwest Oil - Stockton CA | Multigrade | No |
| Multigrade Type | Asphalt Binder Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2022-3 | Date Created | 03/22/2022 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-23-2022-4 | JMF Status | Submittal Authorized For Use |
| Producer Mix ID | HR-22751000 | Authorized Date | 02/18/2022 |
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. | |||