Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-09-11-25
Project Information
Project Identifiers | Project ID: 993742 DEA: 07321804 EFIS: 0716000052 |
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DIST-CO-RTE-PM | 07-LA-405-7.0/12.9 |
Award Date | 07/06/2022 |
Closeout Date | Not set |
Work Description | PLACE MINOR CONCRETE AND HOT MIX ASPHALT. |
Location Description | LOS ANGELES COUNTY IN AND NEAR LONG BEACH, CARSON AND LOS ANGELES AT VARIOUS LOCATIONS FROM 0.1 MILE NORTH OF ROUTE 710 TO ROUTE 110/405 SEPARATION |
QA Service Level | 1 (Verified on 05/11/2022) |
Sample Information
Sample Taken Date | 09/11/2023 | Sample Unique Key | 25 |
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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 | 09/12/2023 |
Sample type | Verification | A brief description of the sample | Crumb Rubber 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 | Zubieta | Last name of sampler or witnessed by | Tec |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | 0468G-23 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | All American Asphalt- Corona | 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 | Scrap Tire |
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Crumb Rubber Modifier Mix Number | 106835 |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2023-09-11-25-1 CTM 208-September 2011 (Verified)
DIME Test ID: 2023-09-11-25-2 CTM 385-July 2022 (Verified)