Sample Taken Date	04/13/2022	Sample Unique Key	51
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	04/29/2022
Sample type	Verification	A brief description of the sample	T-3
The quantity of what the sample constitutes	1 of 1	From where was the sample collected	Manufacturer
First name of sampler or witnessed by	Gabriela	Last name of sampler or witnessed by	Diaz
Title of sampler		Telephone number of sampler
Laboratory sample identification	041322-T3	Linked DIME Sample ID	2022-04-13-30
The fabricator/manufacturer/facility name	Bakersfield, CA	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name

Material Type	Asphalt Binder	Performance Grade	PG 64-16
Modified		Lot number
Sublot number		Tank number
Time of sample		HMA Supplier
Certified Asphalt Supplier	Marathon Petroleum Co. LP - Bakersfield CA	Multigrade	No
Multigrade Type		Asphalt Binder Mix Number	Not set

DIME Test ID: 2022-04-13-51-1 AASHTO T315-20 (Verified)
DIME Test ID: 2022-04-13-51-2 AASHTO T315-20 (Verified)
DIME Test ID: 2022-04-13-51-3 AASHTO T315-20 (Verified)
DIME Test ID: 2022-04-13-51-4 AASHTO T313-19 (Verified)