Sample Record

Owner Lab

  • Blackburn Consulting

DIME Sample ID 2023-02-22-15

Project Information

Project IdentifiersProject ID: 214469
DEA: 030H08U4
EFIS: 0319000029
DIST-CO-RTE-PM03-SAC-50-L0.2/R6.1
Award Date06/30/2020
Closeout DateNot set
Work DescriptionSac 50 Design Build PLEASE NOTE THAT DESIGN BUILDER MUST PERFORM QUALITY VALIDATION TESTING IN ACCORDANCE WITH THE MATERIAL CONTROL SCHEDULE (MCS) FOR ITEMS SUCH AS STRANDS, HS BOLTS, ELASTOMERIC BEARING PADS, JOINT SEALANTS, COUPLERS & WELDED HOOPS, ETC
Location DescriptionFROM 0.1 MILE EAST OF I-5 TO 0.8 MILE EAST OF WATT AVE
QA Service Level1 (Verified on 10/23/2019)

Sample Information

Sample Taken Date02/22/2023 Sample Unique Key15
Date that the sample was received by the laboratory/organization performing the testing02/23/2023 Sample typeQuality Assurance
A brief description of the sample3/4" HMA-SP Oil The quantity of what the sample constitutes2 Oil Cans
From where was the sample collectedJob Site First name of sampler or witnessed byMark
Last name of sampler or witnessed byMahoney Title of samplerInspector
Telephone number of sampler Laboratory sample identification
Linked DIME Sample ID The fabricator/manufacturer/facility nameValero
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeAsphalt Binder Performance GradePG 64-16
Modified Lot number1
Sublot number1 Tank number
Time of sample HMA SupplierTeichert Perkins
Certified Asphalt SupplierValero Marketing & Supply - Benicia CA MultigradeNo
Multigrade Type Asphalt Binder Mix Number
HMA TypeNot set HMA Supplier Mix ID NumberNot set

Submitted Tests

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