Sample Record

Owner Lab

  • CT D11 - KM Lab

DIME Sample ID 2022-08-04-28

Project Information

Project IdentifiersProject ID: 215591
DEA: 112N0724
EFIS: 1119000164
DIST-CO-RTE-PM11-IMP-111-R0.1/R1.2
Award Date05/27/2021
Closeout DateNot set
Work DescriptionCOLD PLANE, PLACE STRESS ABSORBING MEMBRANE INTERLAYER AND RHMA.
Location DescriptionIMPERIAL COUNTY IN CALEXICO FROM 0.1 MILE NORTH OF MEXICO BORDER TO ROUTE 98.
QA Service Level1 (Verified on 07/06/2021)

Sample Information

Sample Taken Date08/04/2022 Sample Unique Key28
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 testing08/05/2022
Sample typeQuality Assurance A brief description of the sample1.5" HMA-A
The quantity of what the sample constitutes16 boxes, 18 bags From where was the sample collectedSupplier
First name of sampler or witnessed bynot provided Last name of sampler or witnessed bynot provided
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameAPI Gateway Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)not provided
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedAt the plant
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1-1/2 inch
The concrete mix design number Lot number
Sublot number HMA Design ID

Submitted Tests

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

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Test File Attachments