Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002227 DEA: 051S6304 EFIS: 0525000068
QA Service Level: 1
DIST-CO-RTE-PM: 05---unknown
Work Description:
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2026-04-14-48
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Verification
Type of Material: Crumb Rubber Modifier
Sample Taken Date: 04/14/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/30/2026
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: Crumb Rubber Scrap
From where was the sample collected: Source
Laboratory sample identification: 26175
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: American Tire Recycling
DIME Test ID: 2026-04-14-48-1
Test Method: CTM 385-July 2022: Method of Test for Crumb Rubber Modifier (CRM)
Verified Date: 05/21/2026
Date Tested: 05/21/2026
Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (530) 713-6823
General Comments for this Test: SCRAP (CRUMB) RUBBER
Test Result Compliance: does not comply
Additional Comments When Verified:
|
Fabric in CRM
|
0.04 %
|
|
Wire in CRM
|
0.02 %
|
