Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2025-10-06-30

Project Information

Project IdentifiersProject ID: 1001225
DEA: 070Y1604
EFIS: 0724000137
DIST-CO-RTE-PM07-LA-210-R9.9/R22.5
Award Date06/26/2025
Closeout DateNot set
Work DescriptionSLAB REPLACEMENT, SLURRY SEAL, AND DIGOUTS.
Location DescriptionLOS ANGELES COUNTY, IN LOS ANGELES, LA CANADA FLINTRIDGE, GLENDALE, AND PASADENA FROM BIG TUJUNGA WASH BRIDGE TO ARROYO BOULEVARD OVERCROSSING
QA Service Level1 (Verified on 07/02/2025)

Sample Information

Sample Taken Date10/06/2025 Sample Unique Key30
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 testing10/09/2025
Sample typeVerification A brief description of the samplePSUE 1/2" RHMA-G-SP 1.0% LAS
The quantity of what the sample constitutes5 bags of comb agg, 1 bag crumb rubber, 1 bag hi-nat From where was the sample collectedManufacturer
First name of sampler or witnessed byDaniel Last name of sampler or witnessed bySequoia
Title of sampler Telephone number of sampler
Laboratory sample identification0638G-25 Linked DIME Sample ID
The fabricator/manufacturer/facility nameAAA-Corona/ Irwindale/ SJR/ Rohm & Haas (Morelife 5000) Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name Bid ItemNot set

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-33-0005
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedAll American Asphalt Irwindale
Where the material sample would have been placed if not sampledAsphalt Paving Primary Aggregate Nominal Size1/2 inch
The concrete mix design number106836 Lot number
Sublot number Aggregate Mix Number

Submitted Tests

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