Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2023-08-22-64
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994806 DEA: 101P5404 EFIS: 1022000134 |
|---|---|
| DIST-CO-RTE-PM | 10-SJ-5-R16.2/R23.9 |
| Award Date | 03/15/2023 |
| Closeout Date | 02/26/2024 |
| Work Description | Cold plane asphalt concrete pavement and resurface with HMA (Type A). |
| Location Description | CONSTRUCTION ON STATE HIGHWAY IN SAN JOAQUIN COUNTY IN AND NEAR LATHROP AND STOCKTON AT VARIOUS LOCATIONS FROM 0.3 MILE SOUTH OF LOUISE AVENUE UNDERCROSSING TO WALKER SLOUGH BRIDGE. |
| QA Service Level | 1 (Verified on 05/08/2023) |
Sample Information
| Sample Taken Date | 08/22/2023 | Sample Unique Key | 64 |
|---|---|---|---|
| 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 | 10/09/2023 |
| Sample type | Acceptance | A brief description of the sample | PG 70-10 Rubberized Binder |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Supplier |
| First name of sampler or witnessed by | T. | Last name of sampler or witnessed by | Fulkerson |
| Title of sampler | Technician | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Teichert Vernalis | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Asphalt Rubber Binder | Asphalt modifier supplier | |
|---|---|---|---|
| Performance Grade | PG 64-16 | Lot number | 2 |
| Sublot number | Asphalt Rubber Binder Mix Number |
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. | |||