Sample Record

Owner Lab

  • Blackburn Consulting

DIME Sample ID 2023-10-20-20

Project Information

Project IdentifiersProject ID: 993639
DEA: 031J0104
EFIS: 0320000059
DIST-CO-RTE-PM03-SAC,YOL-99,113-19.7,23.1,R1.1,R2.1
Award Date10/14/2022
Closeout Date04/07/2025
Work DescriptionCONSTRUCT CURB RAMPS, SIDEWALKS AND MODIFY SIGNAL SYSTEMS.
Location DescriptionSACRAMENTO AND YOLO COUNTIES AT VARIOUS LOCATIONS
QA Service Level1 (Verified on 11/22/2022)

Sample Information

Sample Taken Date10/20/2023 Sample Unique Key20
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 testing10/24/2023
Sample typeQuality Control A brief description of the sample3/4" HMA
The quantity of what the sample constitutes2 HMA Boxes From where was the sample collectedManufacturer
First name of sampler or witnessed byJesus Last name of sampler or witnessed byTostado
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 TypeHot Mix Asphalt HMA TypeType A HMA
HMA Grading3/4 inch Lot number
Sublot number HMA 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