Sample Record

Owner Lab

  • CT HQ - Sacramento Materials Management Branch Field Office

DIME Sample ID 2021-07-28-42

Project Information

Project IdentifiersProject ID: 99999
DEA: 0322222
DIST-CO-RTE-PM03-SAC,OMG-888,99,80-0.6-0.6
Award DateNot set
Closeout DateNot set
Work DescriptionTHIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location DescriptionTHIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
QA Service Level (Verified on 04/05/2013)

Sample Information

Sample Taken Date07/28/2021 Sample Unique Key42
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing07/30/2021
Sample typeVerification A brief description of the samplePG Binder
The quantity of what the sample constitutes1 Quart Can From where was the sample collectedSupplier
First name of sampler or witnessed byKevin Last name of sampler or witnessed byoluoha
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCCA-Coachella 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 M
ModifiedYes Lot number
Sublot number Tank number
Time of sample HMA Supplier
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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Sample File Attachments

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Test File Attachments