Sample Record

Owner Lab

  • Blackburn Consulting

DIME Sample ID 2022-08-30-1

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 Date08/30/2022 Sample Unique Key1
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 testing08/30/2022
Sample typeQuality Control A brief description of the sample3/4 HMA
The quantity of what the sample constitutes2 boxes 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 nameTeichert Perkins Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeHot Mix Asphalt HMA TypeType A HMA
HMA Grading3/4 inch Lot number
Sublot number HMA Mix NumberNot set

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