Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2025-09-16-39

Project Information

Project IdentifiersProject ID: 1000665
DEA: 081K4004
EFIS: 0819000031
DIST-CO-RTE-PM08-RIV-15-3.5/6.8
Award Date01/29/2025
Closeout DateNot set
Work DescriptionHMA (TYPE A), RDWY EXC, STR CONC RET WALL, RUBBERIZED HMA (OGFC).
Location DescriptionTEMECULA FROM 0.1 MI NORTH OF TEMECULA PARKWAY TO 0.2 MI NORTH OF WINCHESTER ROAD
QA Service Level1 (Verified on 01/13/2025)

Sample Information

Sample Taken Date09/16/2025 Sample Unique Key39
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 testing09/17/2025
Sample typeVerification A brief description of the sampleHi-Nat
The quantity of what the sample constitutes1Bag Hi-Nat From where was the sample collectedManufacturer
First name of sampler or witnessed byJACOB Last name of sampler or witnessed byMCPHERSON
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameWorld oil, SJR, CRM, M.M. (91-33-0014) 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 Number51R003ARSPO

Submitted Tests

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