Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2023-05-16-57

Project Information

Project IdentifiersProject ID: 215349
DEA: 081C0824
EFIS: 0816000087
DIST-CO-RTE-PM08-RIV-10-R104.9/R134.2
Award Date03/24/2021
Closeout Date01/06/2025
Work DescriptionPLACE HMA (TYPE A), JPCP AND IMPORTED BORROW.
Location DescriptionRIVERSIDE COUNTY FROM ROUTE 10/177 SEPARATION TO 1.1 MILES WEST OF WILEY'S WELL RD OC
QA Service Level1 (Verified on 03/01/2021)

Sample Information

Sample Taken Date05/16/2023 Sample Unique Key57
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 testing05/25/2023
Sample typeVerification A brief description of the samplePSUE 3/4" HMA-A-SP R24 1.0% LSM
The quantity of what the sample constitutes2 Bags of Virgin Agg., 2 Bags of Marinated Blend Agg., 1 Bag each Coarse and Fine RAP From where was the sample collectedManufacturer
First name of sampler or witnessed byFernando Last name of sampler or witnessed byCarranza
Title of sampler Telephone number of sampler
Laboratory sample identification0272A-23 Linked DIME Sample ID
The fabricator/manufacturer/facility nameFisher Sand and Gravel - Tempe 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)CM203
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedBelt Cut at Fisher Sand and Gravel
Where the material sample would have been placed if not sampledAsphalt Paving Primary Aggregate Nominal Size3/4 inch
The concrete mix design numberCA125MA Lot number
Sublot number Aggregate Mix Number

Submitted Tests

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