Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2022-02-28-8

Project Information

Project IdentifiersProject ID: 213707
DEA: 081C38U4
EFIS: 0817000196
DIST-CO-RTE-PM08-RIV-10-6.7/R25.1
Award Date11/26/2019
Closeout Date11/01/2023
Work DescriptionRemove concrete pavement and base, and place HMA and JPCP
Location DescriptionROUTE 10/60 SEPARATION IN BEAUMONT TO ROUTE 10/111 SEPARATION NEAR CABAZON.
QA Service Level1 (Verified on 01/09/2020)

Sample Information

Sample Taken Date02/28/2022 Sample Unique Key8
Date that the sample was received by the laboratory/organization performing the testing03/01/2022 Sample typeDepartment Acceptance
A brief description of the sampleAcceptance 3/4" HMA-A-SP R24 0.5% LAS The quantity of what the sample constitutes8 Bags Of Agg., 2 Bags Rap
From where was the sample collectedManufacturer First name of sampler or witnessed byZachariah
Last name of sampler or witnessed byReush Title of sampler
Telephone number of sampler Laboratory sample identification0146A-22
Linked DIME Sample ID The fabricator/manufacturer/facility nameCalifornia Commercial Asphalt - Coachella
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)91-33-0084
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number43417615 A detailed description of where the material sample was collectedBelt Cut at California Commercial Asphalt Coachella Plant
Where the material sample would have been placed if not sampledAsphalt Paving Primary Aggregate Nominal Size3/4 inch
The concrete mix design number Lot number
Sublot number Aggregate Mix NumberNot set

Submitted Tests

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