Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2026-07-15-64

Project Information

Project IdentifiersProject ID: 1002260
DEA: 081N8104
EFIS: 0823000050
DIST-CO-RTE-PM08-SBD-40-R135.9/R143.8
Award DateNot set
Closeout DateNot set
Work DescriptionRHMA-open graded (OGFC), cold plane AC Pvmt, & replace AC Surf.
Location DescriptionNot set
QA Service Level1 (Verified on 06/02/2026)

Sample Information

Sample Taken Date07/15/2026 Sample Unique Key64
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 testing07/21/2026
Sample typeJMF Verification A brief description of the sample1/2" RHMA-G 1.0% LSM
The quantity of what the sample constitutes3Bgs Comb Cld-feed Ag 3Bgs 1/2",3/8" Crshd Ag Vir ea 2Bgs Mfd Sand,1Bg Crum Rbr,1Bag Hi-Nat From where was the sample collectedManufacturer
First name of sampler or witnessed byBenjamin Last name of sampler or witnessed byAlfaro
Title of sampler Telephone number of sampler
Laboratory sample identification0425G-26 Linked DIME Sample ID
The fabricator/manufacturer/facility nameBlue Diamond - Victorville 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 Number

Submitted Tests

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