Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 11111 DEA: CRM EFIS: CRM
QA Service Level:
DIST-CO-RTE-PM: ---
Work Description: Special project for submitting Sample information for Crumb Rubber Modifier (CRM). Crumb Rubber Modifier (CRM) is used in Asphalt Rubber Binder Chip Seal and Rubberized Hot Mix Asphalt (RHMA).
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2026-04-17-50
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Acceptance
Type of Material: Crumb Rubber Modifier
Sample Taken Date: 04/17/2026
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 Of Crumb Rubber
A brief description of the sample: Crumb Rubber
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Liberty Tire Recycling Utah
DIME Test ID: 2026-04-17-50-1
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 Hot Mix Asphalt 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: complies
Additional Comments When Verified:
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Fabric in CRM
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0.01 %
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Wire in CRM
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no data0 %
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