Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2023-05-08-65

Project Information

Project IdentifiersProject ID: 993446
DEA: 120J34U4
EFIS: 1218000034
DIST-CO-RTE-PM12-ORA-55,55-29.6,R6.4/10.3
Award Date05/27/2022
Closeout DateNot set
Work DescriptionCONSTR BRIDGES, RW, SW, JPCP, HMA PVMT, DRAINAGE AND ELECT SYSTEMS.
Location DescriptionORANGE COUNTY IN IRVINE, SANTA ANA, AND TUSTIN ON ROUTE 5 AT NEWPORT AVENUE UNDERCROSSING AND ON ROUTE 55 FROM 0.4 MILE NORTH OF ROUTE 55/405 SEPARATION TO 0.1 MILE SOUTH OF ROUTE 5/55 SEPARATION
QA Service Level1 (Verified on 06/24/2022)

Sample Information

Sample Taken Date05/08/2023 Sample Unique Key65
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 testing05/26/2023
Sample typeVerification A brief description of the sampleCRM Scrap
The quantity of what the sample constitutes1 Bag of CRM Scrap 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 identification0273G-23 Linked DIME Sample ID
The fabricator/manufacturer/facility nameVulcan Materials - Corona Drum Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name Bid ItemNot set

Material Information

Material TypeCrumb Rubber Modifier CRM TypeScrap Tire
Crumb Rubber Modifier Mix Number226108 CORD SJR

Submitted Tests

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