Sample Record

Owner Labs

  • Blackburn Consulting
  • CT HQ - Sacramento Asphalt Binder Laboratory

DIME Sample ID 2022-08-25-19

Project Information

Project IdentifiersProject ID: 993193
DEA: 031H18U4
EFIS: 0321000106
DIST-CO-RTE-PM03-NEV-80-13.0/16.5
Award Date11/04/2021
Closeout Date12/14/2023
Work DescriptionROADWAY EXCAVATION, JPCP AND FURNISH POLYESTER CONCRETE OVERLAY.
Location DescriptionNEVADA COUNTY IN AND NEAR TRUCKEE FROM 0.2 MILE WEST OF DONNER PARK OVERCROSSING TO ROUTE 89/267 SEPARATION
QA Service Level1 (Verified on 08/23/2021)

Sample Information

Sample Taken Date08/25/2022 Sample Unique Key19
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 testing08/26/2022
Sample typeQuality Control A brief description of the sampleOil
The quantity of what the sample constitutes1 Oil Can From where was the sample collectedJob Site
First name of sampler or witnessed byDustan Last name of sampler or witnessed byKliethermes
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameMartis Valley 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 64-28
ModifiedNo Lot number1
Sublot number3 Tank number
Time of sample HMA Supplier
Certified Asphalt SupplierPacific Northwest Oil - Stockton CA MultigradeNo
Multigrade Type 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