Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2026-03-23-50

Project Information

Project IdentifiersProject ID: 1000851
DEA: 07351704
EFIS: 0718000204
DIST-CO-RTE-PM07-VEN-118,118-15.6/R17.9
Award Date03/25/2025
Closeout DateNot set
Work DescriptionCOLD PLANE AC PAVEMENT AND PLACE RUBBERIZED HMA.
Location DescriptionVENTURA COUNTY IN MOORPARK AT VARIOUS LOCATIONS
QA Service Level1 (Verified on 03/11/2025)

Sample Information

Sample Taken Date03/23/2026 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 testing04/06/2026
Sample typeVerification A brief description of the samplePSUE 3/4" RHMA-G-SP 0.5% LAS
The quantity of what the sample constitutes4 bags comb agg, 1 bag EA CRM (Scrap & Hi-Nat) From where was the sample collectedManufacturer
First name of sampler or witnessed byVictor Last name of sampler or witnessed byPham
Title of sampler Telephone number of sampler
Laboratory sample identification0171G-26 Linked DIME Sample ID
The fabricator/manufacturer/facility nameIngevity/ Valero/ Fish Canyon Irwindale 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)91-19-0035
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 collectedBelt Cut at Vulcan Sun Valley Plant
Where the material sample would have been placed if not sampledAsphalt Paving Primary Aggregate Nominal Size3/4 inch
The concrete mix design number226108M SVA VLO Lot number
Sublot number Aggregate Mix Number

Submitted Tests

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