Sample Record

Owner Lab

  • Blackburn Consulting

DIME Sample ID 2023-07-16-5

Project Information

Project IdentifiersProject ID: 994310
DEA: 034F6504
EFIS: 0314000233
DIST-CO-RTE-PM03-YOL-50,80-0.0/2.5,4.1/R11.4
Award Date04/07/2023
Closeout DateNot set
Work DescriptionCRCP, HMA (TYPE A), RDWY EXC, CLASS 2 AB, FIBER OPTIC CABLE SYSTEMS.
Location DescriptionYOLO COUNTY IN AND NEAR WEST SACRAMENTO ON ROUTE 80 FROM 1.7 MILES EAST OF MACE BOULEVARD OVERCROSSING TO SACRAMENTO RIVER BRIDGE AND OVERHEAD (BRYTE BEND) AND ON ROUTE 50 FROM ROUTE 80 JUNCTION TO JEFFERSON BOULEVARD UNDERCROSSING
QA Service Level1 (Verified on 10/04/2022)

Sample Information

Sample Taken Date07/16/2023 Sample Unique Key5
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 testing07/19/2023
Sample typeQuality Assurance A brief description of the samplePG 64-16
The quantity of what the sample constitutes1 Oil Can From where was the sample collectedJob Site
First name of sampler or witnessed byJim Last name of sampler or witnessed byCarroll
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 TypeAsphalt Binder Performance GradePG 64-16
Modified Lot number
Sublot number Tank number
Time of sample HMA Supplier
Certified Asphalt SupplierPacific Northwest Oil - Stockton 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