Sample Record
Owner Lab
- Blackburn Consulting
DIME Sample ID 2022-09-24-6
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993193 DEA: 031H18U4 EFIS: 0321000106 |
|---|---|
| DIST-CO-RTE-PM | 03-NEV-80-13.0/16.5 |
| Award Date | 11/04/2021 |
| Closeout Date | 12/14/2023 |
| Work Description | ROADWAY EXCAVATION, JPCP AND FURNISH POLYESTER CONCRETE OVERLAY. |
| Location Description | NEVADA COUNTY IN AND NEAR TRUCKEE FROM 0.2 MILE WEST OF DONNER PARK OVERCROSSING TO ROUTE 89/267 SEPARATION |
| QA Service Level | 1 (Verified on 08/23/2021) |
Sample Information
| Sample Taken Date | 09/24/2022 | Sample Unique Key | 6 |
|---|---|---|---|
| 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 testing | 09/24/2022 |
| Sample type | Quality Control | A brief description of the sample | SS-1H 1jug tack coat emulsion |
| The quantity of what the sample constitutes | 1 jug | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Dustan | Last name of sampler or witnessed by | Kliethermes |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Pacific Northwest Oil | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Asphalt Modifier | Asphalt Modifier Type | tack coat |
|---|---|---|---|
| Asphalt Modifier Mix Number | Not set |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||