Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2025-09-05-44
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Project Information
| Project Identifiers | Project ID: 1000611 DEA: 120R32U4 EFIS: 1222000054 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-55-0.2/R17.8 |
| Award Date | 02/07/2025 |
| Closeout Date | Not set |
| Work Description | COLD PLANE, PLACE RHMA, REPLACE CB, SIGNS AND MODIFY LIGHTING SYSTEM. |
| Location Description | ORANGE COUNTY FROM 0.1 MILE SOUTH OF ROUTE 55/1 SEPARATION IN NEWPORT BEACH TO ROUTE 55/91 SEPARATION IN ANAHEIM |
| QA Service Level | 1 (Verified on 09/30/2024) |
Sample Information
| Sample Taken Date | 09/05/2025 | Sample Unique Key | 44 |
|---|---|---|---|
| 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 | 09/11/2025 |
| Sample type | Verification | A brief description of the sample | 1BAG OF CRM RUBBER |
| The quantity of what the sample constitutes | 1BAG CRM RUBBER | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Drake | Last name of sampler or witnessed by | Gustafson |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 05540-25 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | WORLD OIL, M.M-EAGLE VALLEY | 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 | 51R003ARSPO |
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. | |||