Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2022-10-24-54
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 | 07/09/2024 |
| 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 | 54 |
|---|---|---|---|
| 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 | 12/27/2022 |
| Sample type | Quality Control | A brief description of the sample | CRM - Hi Nat |
| The quantity of what the sample constitutes | bag | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Caltrans | Last name of sampler or witnessed by | AAA- QC |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | AAA-Irwindale | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Bid Item | Not set |
Material Information
| Material Type | Crumb Rubber Modifier | CRM Type | High Natural |
|---|---|---|---|
| Crumb Rubber Modifier Mix Number |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-10-24-54-1 CTM 385-November 2016 (Verified)
DIME Test ID: 2022-10-24-54-2 CTM 208-September 2011 (Verified)
