Sample Record

Owner Lab

  • Blackburn Consulting

DIME Sample ID 2022-08-19-13

Project Information

Project IdentifiersProject ID: 213411
DEA: 030H10U4
EFIS: 0317000246
DIST-CO-RTE-PM03-SAC-5-9.7/24.9
Award Date05/01/2019
Closeout Date02/22/2024
Work DescriptionNot set
Location DescriptionConstruction on state highway in Sacramento County in and near Sacramento from 1.1 miles south of Elk Grove Boulevard to American River Viaduct
QA Service Level1 (Verified on 07/19/2019)

Sample Information

Sample Taken Date08/19/2022 Sample Unique Key13
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 testing08/19/2022
Sample typeQuality Control A brief description of the sampleTack Coat
The quantity of what the sample constitutes1 Oil Jug From where was the sample collectedJob Site
First name of sampler or witnessed byRobert Last name of sampler or witnessed bySears
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameNorthwest Pacific Oil 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 SupplierPacific Northwest Oil - Stockton CA MultigradeNo
Multigrade TypePG 64-16 / PG 64-10 Asphalt Binder Mix NumberNot set

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