Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2025-08-03-22

Project Information

Project IdentifiersProject ID: 1000392
DEA: 07349904
EFIS: 0718000167
DIST-CO-RTE-PM07-LA-710-6.0/14.1
Award Date09/12/2024
Closeout DateNot set
Work DescriptionCONSTRUCT MVPS, MGS, ROCK BLANKETS,AND PAVE BEYOND THE GORE.
Location DescriptionLOS ANGELES COUNTY IN LONG BEACH AND COMPTOM FROM SHORELINE DRIVE TO 0.2 MILE NORTH OF ALONDRA BOULEVARD OVERCROSSING
QA Service Level1 (Verified on 08/12/2024)

Sample Information

Sample Taken Date08/03/2025 Sample Unique Key22
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 testing09/10/2025
Sample typeVerification A brief description of the samplePSUE, 3/4" RHMA-G-SP 0.5% LAS
The quantity of what the sample constitutes2 Bags EA of Hi-Nat & CRM From where was the sample collectedManufacturer
First name of sampler or witnessed byGeorge Last name of sampler or witnessed byG3-QC
Title of sampler Telephone number of sampler
Laboratory sample identification0550G-25 Linked DIME Sample ID
The fabricator/manufacturer/facility nameAll American-Irwindale 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 TypeScrap Tire
Crumb Rubber Modifier Mix Number

Submitted Tests

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