Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2025-08-01-51
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 1000891 DEA: 120U8104 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-57-11.0/22.5 |
| Award Date | 04/17/2025 |
| Closeout Date | Not set |
| Work Description | REMOVE AND REPLACE RHMA, PAVEMENT MARKING AND ROADSIDE SIGN. |
| Location Description | ORANGE COUNTY AT VARIOUS LOCATIONS FROM ROUTE 5/22/57 SEPARATION TO 0.3 MILE SOUTH OF LOS ANGELES COUNTY LINE |
| QA Service Level | 1 (Verified on 01/23/2025) |
Sample Information
| Sample Taken Date | 08/01/2025 | Sample Unique Key | 51 |
|---|---|---|---|
| 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 | 08/20/2025 |
| Sample type | Verification | A brief description of the sample | scrap |
| The quantity of what the sample constitutes | 1 Bag Of Crumb Rubber Scrap | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | VICTOR | Last name of sampler or witnessed by | Victor Capacete QC |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0521G-25 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Belt cut at all America asphalt corona | 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 | 106836 |
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. | |||