Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-09-11-32
Project Information
| Project Identifiers | Project ID: 994621 DEA: 120T6404 EFIS: 1222000074 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-72-11.4/12.0 |
| Award Date | 04/13/2023 |
| Closeout Date | Not set |
| Work Description | PLACE RHMA-G AND MODIFY SIGNAL AND LIGHTING SYSTEM. |
| Location Description | ORANGE COUNTY IN LA HABRA FROM JUNCTION 39 AT WHITTIER-BEACH TO VALLEY HOME AVENUE |
| QA Service Level | 1 (Verified on 07/07/2023) |
Sample Information
| Sample Taken Date | 09/11/2023 | Sample Unique Key | 32 |
|---|---|---|---|
| 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 | 09/14/2023 |
| Sample type | Verification | A brief description of the sample | Scrap Crumb Rubber |
| The quantity of what the sample constitutes | 1 Bag Of Crumb Rubber | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Cuong | Last name of sampler or witnessed by | Pham |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0472G-23 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Vulcan Materials-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 | Scrap Tire |
|---|---|---|---|
| Crumb Rubber Modifier Mix Number | 326120M IRW LTR |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2023-09-11-32-1 CTM 208-September 2011 (Verified)
DIME Test ID: 2023-09-11-32-2 CTM 385-July 2022 (Verified)
