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Testing Report for 2021-04-19-2-2

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

DEA: ASCP
EFIS: ASCP
Project ID: 44444
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for Asphalt Supplier Certification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-04-19-2
TL Number from the TL Form:
Sample Submitted By Organization: Veleroo - Coolidge
Sample Organization Contact: 111-111-1111
Type of Sample: Quality Control
Type of Material: Asphalt Binder
Sample Taken Date: 4/19/2021
Date that the sample was received by the laboratory/organization performing the testing: 4/19/2021
The quantity of what the sample constitutes: 1 of 2, split sample
A brief description of the sample: Asphalt Binder PG64-16 Multi-Grade
From where was the sample collected: Fabricator
Laboratory sample identification: 641641621
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Ergon Asphalt and Emulsions

Material Information

Performance Grade: PG 64-16
Modified: No
Lot number:
Sublot number:
Tank number: 5
Time of sample: 0600
HMA Supplier:
Asphalt Binder Supplier: Ergon Asphalt & Emulsions Incorporated - Las Vegas NV
Multigrade: Yes
Multigrade Type:

Test Information

DIME Test ID: 2021-04-19-2-2
Test Method: AASHTO T51-13: Standard Method of Test for Ductility of Asphalt Materials (Asphalt Binder)
Date Tested: 4/19/2021
Verified Date: 4/19/2021
Submitted By Organization: Veleroo - Coolidge
Organization Address: 123 Abc St,
Organization City: Coolidge
Organization State: AZ
Organization Zipcode: 88888
Organization Email:
Organization Phone: 111-111-1111
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Is a normal test obtainable?: Yes
Number of replicates tested: Three
Ductility of test #1 (D1): 120 cm
Ductility of test #2 (D2): 120 cm
Ductility of test #3 (D3): 120 cm
Ductility of sample: 120 cm