DIME - Sample Record for DIME Sample ID 2022-10-24-20

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DIME » All Projects » Project - DEA: 07311704 » Sample 2022-10-24-20 » Sample Details

Sample Record

Owner Lab

CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2022-10-24-20

Project Information

Project Identifiers	Project ID: 214493 DEA: 07311704 EFIS: 0715000013
DIST-CO-RTE-PM	07-LA-134-0.0/R13.3
Award Date	04/16/2020
Closeout Date	Not set
Work Description	CONCRETE SLAB REPLACEMENT, HMA PAVING, ELECTRICAL AND LANDSCAPE WORK.
Location Description	LOS ANGELES COUNTY IN LOS ANGELES, BURBANK, GLENDALE AND PASADENA FROM ROUTE 101/134 SEPARATION TO JUNCTION OF ROUTE 210/710
QA Service Level	1 (Verified on 04/15/2020)

Sample Information

Sample Taken Date	10/24/2022	Sample Unique Key	20
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 testing	10/27/2022
Sample type	Verification	A brief description of the sample	Hi-Natural
The quantity of what the sample constitutes	1 Bag Hi-Nat	From where was the sample collected	Manufacturer
First name of sampler or witnessed by	Victor	Last name of sampler or witnessed by	Pham
Title of sampler		Telephone number of sampler
Laboratory sample identification	0713G-22	Linked DIME Sample ID
The fabricator/manufacturer/facility name	All American Asphalt-Irwindale	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name

Material Information

Material Type	Crumb Rubber Modifier	CRM Type	High Natural
Crumb Rubber Modifier Mix Number

Submitted Tests

DIME Test ID	Test Method	Tester Name, Testing Lab	Date Tested	Submitted By	Verified?	Release Date	Test Comments	Actions
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Sample File Attachments

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Test File Attachments