Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2024-11-08-39
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214697 DEA: 07307104 EFIS: 0714000213 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-101-32.8 |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | CONSTRUCT BRIDGE. |
| Location Description | LOS ANGELES COUNTY IN AND NEAR AGOURA HILLS FROM 0.1 MILE WEST OF LIBERTY CANYON ROAD UNDERCROSSING TO 0.6 MILE EAST OF PALO COMADO OVERCROSSING |
| QA Service Level | 1 (Verified on 07/12/2021) |
Sample Information
| Sample Taken Date | 11/08/2024 | Sample Unique Key | 39 |
|---|---|---|---|
| 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 testing | 11/13/2024 |
| Sample type | Verification | A brief description of the sample | JMF 3/4" RHMA-G-SP 0.5% LAS |
| The quantity of what the sample constitutes | 1 Bag of CRM Scrap | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | John | Last name of sampler or witnessed by | Meijah |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0621G-24 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Ingevity, Valero, Fish Canyon Irwindale | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Bid Item | Not set |
Material Information
| Material Type | Crumb Rubber Modifier | CRM Type | Scrap Tire |
|---|---|---|---|
| Crumb Rubber Modifier Mix Number | 226108M SVA VLO |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Date Added | Verified? | Release Date | Test Comments | Privacy Level | Actions |
|---|---|---|---|---|---|---|---|---|---|
| No results found. | |||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||