Sample Record

Owner Lab

  • CT D03 - Olivehurst Northern Regional Laboratory

DIME Sample ID 2022-02-14-58

Project Information

Project IdentifiersProject ID: 214572
DEA: 034E62U4
EFIS: 0319000068
DIST-CO-RTE-PM03-ED-50-18.5/24.2
Award Date05/04/2020
Closeout DateNot set
Work DescriptionCONSTRUCT UC, MED BARRIER, DRAINAGE SYSTEMS & HMA OVERLAY.
Location DescriptionEL DORADO COUNTY IN AND NEAR PLACERVILLE FROM MOSQUITO ROAD UNDERCROSSING TO SCHNELL SCHOOL ROAD UNDERCROSSING AND FROM 0.2 MILE WEST OF STILL MEADOW ROAD TO 0.2 MILE EAST OF CARSON ROAD
QA Service Level1 (Verified on 03/18/2020)

Sample Information

Sample Taken Date02/14/2022 Sample Unique Key58
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 testing03/11/2022
Sample typeVerification A brief description of the samplePG 64-16 Valero
The quantity of what the sample constitutesCans of oil From where was the sample collectedSupplier
First name of sampler or witnessed byMike Last name of sampler or witnessed byO'Halloran
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameValero 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
Certified Asphalt SupplierValero Marketing & Supply - Benicia CA MultigradeNo
Multigrade Type Asphalt Binder Mix NumberNot set

JMF Information

Verification IDJMF3513-2022-10 Date Created05/16/2022
JMF Submittal IDJMF3511-23-2022-15 JMF StatusSubmittal Authorized For Use
Producer Mix IDGL202101-SP Authorized Date03/29/2022

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments