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
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 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

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

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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