Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2024-09-25-53

Project Information

Project IdentifiersProject ID: 994869
DEA: 073237U4
EFIS: 0720000224
DIST-CO-RTE-PM07-VEN-150-13.3/19
Award Date03/27/2023
Closeout DateNot set
Work DescriptionPLACE HMA (TYPE A) AND COLD PLANE ASPHALT
Location DescriptionVENTURA COUNTY IN AND NEAR OJAI FROM BURNHAM ROAD TO GORHAM ROAD
QA Service Level1 (Verified on 06/26/2023)

Sample Information

Sample Taken Date09/25/2024 Sample Unique Key53
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing09/27/2024
Sample typeVerification A brief description of the sample3/4''HMA-A-SP R25 0.50%LAS,PG64-10(VIRGIN OIL PG58-16)
The quantity of what the sample constitutes4bags comb agg(3/4,1/2, 3/8,Washed man fines),2bags Rap From where was the sample collectedSource
First name of sampler or witnessed byKevin Last name of sampler or witnessed byHopkins
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility namevulcan saticoy Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-19-0020
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedVulcan Saticoy/INGEVITY/PALMDALE/FISH CANYON-IRW
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/4 inch
The concrete mix design number Lot number
Sublot number Aggregate 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