Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2025-08-14-81

Project Information

Project IdentifiersProject ID: 1000802
DEA: 07346804
EFIS: 0718000079
DIST-CO-RTE-PM07-VEN-232-0.4/R4.1
Award Date02/04/2025
Closeout DateNot set
Work DescriptionCOLD PLANE AND OVERLAY WITH HMA & RHMA.
Location DescriptionVENTURA COUNTY IN AND NEAR OXNARD FROM ROUTE 232/101 SEPARATION TO ROUTE 118
QA Service Level1 (Verified on 01/27/2025)

Sample Information

Sample Taken Date08/14/2025 Sample Unique Key81
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 testing08/22/2025
Sample typeVerification A brief description of the sample3/4" RWMA G SP .25% EVO
The quantity of what the sample constitutes2 Qts of Hi-Nat From where was the sample collectedManufacturer
First name of sampler or witnessed byJohn Last name of sampler or witnessed byMejia
Title of sampler Telephone number of sampler
Laboratory sample identification0524G-25 Linked DIME Sample ID
The fabricator/manufacturer/facility nameBELT CUT AT VULCAN SATICOY Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name Bid ItemNot set

Material Information

Material TypeCrumb Rubber Modifier CRM TypeHigh Natural
Crumb Rubber Modifier Mix Number226110 SAT VLO

Submitted Tests

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