Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2026-03-20-30

Project Information

Project IdentifiersProject ID: 1000826
DEA: 07344504
EFIS: 0718000061
DIST-CO-RTE-PM07-VEN-150-
Award Date02/14/2025
Closeout DateNot set
Work DescriptionCOLD PLANE AND OVERLAY, MODIFY TRAFFIC SIGNALS AND REPLACE CURB RAMPS.
Location DescriptionVENTURA COUNTY IN SANTA PAULA FROM 0.2 MILE NORTH OF BRIDGE ROAD TO SANTA MARIA STREET
QA Service Level1 (Verified on 01/27/2025)

Sample Information

Sample Taken Date03/20/2026 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 testing03/26/2026
Sample typeVerification A brief description of the sampleCrumb Rubber Scrap
The quantity of what the sample constitutes3 quarts of crumb rubber scrap From where was the sample collectedManufacturer
First name of sampler or witnessed byIsaac Last name of sampler or witnessed byOrtega G/QC
Title of sampler Telephone number of sampler
Laboratory sample identification0162G-26 Linked DIME Sample ID
The fabricator/manufacturer/facility nameBig Rock/ San Joaquin Refinery/ Morlife 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 Number1556

Submitted Tests

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