Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2022-07-01-33

Project Information

Project IdentifiersProject ID: 993535
DEA: 081M1104
EFIS: 0821000078
DIST-CO-RTE-PM08-SBD-215-10.0/17.2
Award Date03/14/2022
Closeout Date12/05/2022
Work DescriptionHMA, COLD PLANE AC PAVEMENT, AND TRAFFIC STRIPE TAPE.
Location DescriptionSAN BERNARDINO COUNTY?FROM 0.1 MILE NORTH OF 27TH STREET TO 0.1 MILE SOUTH OF DEVORE ROAD
QA Service Level1 (Verified on 02/21/2022)

Sample Information

Sample Taken Date07/01/2022 Sample Unique Key33
Date that the sample was received by the laboratory/organization performing the testing07/11/2022 Sample typeVerification
A brief description of the sampleJMF 3/4" HMA-A-SP 0.50% LAS The quantity of what the sample constitutes4 Bags Belt Cut Agg.,
From where was the sample collectedManufacturer First name of sampler or witnessed byVulcan
Last name of sampler or witnessed byQC Title of sampler
Telephone number of sampler Laboratory sample identification0440A-22
Linked DIME Sample ID The fabricator/manufacturer/facility nameVulcan-San Bernardino Portable
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, 91-36-0107
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number224108 SBP SJR A detailed description of where the material sample was collectedBelt Cut at Vulcan Materials-San Bernardino
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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