Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-04-29-12
Project Information
| Project Identifiers | Project ID: 993446 DEA: 120J34U4 EFIS: 1218000034 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-55,55-29.6,R6.4/10.3 |
| Award Date | 05/27/2022 |
| Closeout Date | Not set |
| Work Description | CONSTR BRIDGES, RW, SW, JPCP, HMA PVMT, DRAINAGE AND ELECT SYSTEMS. |
| Location Description | ORANGE 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 Level | 1 (Verified on 06/24/2022) |
Sample Information
| Sample Taken Date | 04/29/2023 | Sample Unique Key | 12 |
|---|---|---|---|
| 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 | 05/26/2023 |
| Sample type | Verification | A brief description of the sample | 1 Bag of CRM Scrap |
| The quantity of what the sample constitutes | 1 Bag of CRM Scrap | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Vulcan | Last name of sampler or witnessed by | QC |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0274G-23 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Vulcan Materials Corona Drum | 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 | Scrap Tire |
|---|---|---|---|
| Crumb Rubber Modifier Mix Number | 326120 CORD SJR |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2023-04-29-12-1 CTM 208-September 2011 (Verified)
DIME Test ID: 2023-04-29-12-2 CTM 385-November 2016 (Verified)
