Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2025-09-15-50

Project Information

Project IdentifiersProject ID: 995057
DEA: 07321604
EFIS: 0716000049
DIST-CO-RTE-PM07-LA-1-0.0/18.0
Award Date12/20/2023
Closeout DateNot set
Work DescriptionCOLD PLANE AND OVERLAY AC PAVEMENT AND UPGRADE ADA CURB RAMPS.
Location DescriptionLOS ANGELES COUNTY FROM STUDEBAKER ROAD TO PASEO DE LAS DELICIAS
QA Service Level1 (Verified on 08/08/2023)

Sample Information

Sample Taken Date09/15/2025 Sample Unique Key50
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 testing09/22/2025
Sample typeVerification A brief description of the sampleCrum Rubber Modifier
The quantity of what the sample constitutes1 Bag Ea Crum Rubber From where was the sample collectedManufacturer
First name of sampler or witnessed byRMA & RJN - QC Last name of sampler or witnessed byRMA & RJN - QC
Title of sampler Telephone number of sampler
Laboratory sample identification0595G-25 Linked DIME Sample ID
The fabricator/manufacturer/facility nameRJ Noble Orange Plant 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 Number49R003ARSPWEO

Submitted Tests

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