Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-10-11-115
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Project Information
| Project Identifiers | Project ID: 994962 DEA: 07357304 EFIS: 0719000062 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-5-6.6/13.1 |
| Award Date | 04/27/2023 |
| Closeout Date | Not set |
| Work Description | REPLACE CONCRETE SLABS AND MEDIAN BARRIER, |
| Location Description | LOS ANGELES COUNTY IN SANTA FE SPRINGS, DOWNEY AND CITY OF COMMERCE FROM 0.2 MILE SOUTH OF ROUTE 5/605 SEPARATION TO 0.1 MILE NORT |
| QA Service Level | 1 (Verified on 07/13/2023) |
Sample Information
| Sample Taken Date | 10/11/2023 | Sample Unique Key | 115 |
|---|---|---|---|
| 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 | 11/06/2023 |
| Sample type | Verification | A brief description of the sample | JMF 1/2" RHMA-G-SP 1.0% LAS |
| The quantity of what the sample constitutes | 4 bags of Agg, 1 bag of CRM Scrap and 1 bag of Hi-Nat | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Gerardo | Last name of sampler or witnessed by | Zubieta |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0565G-23 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | AAA-Corona/ Irwindale/ SJR/ Rohm & HAAS (Morelife) | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-33-0005 |
|---|---|---|---|
| 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 collected | All American Asphalt - Irwindale | |
| Where the material sample would have been placed if not sampled | Asphalt Paving | Primary Aggregate Nominal Size | 1/2 inch |
| The concrete mix design number | 106836 | Lot number | |
| Sublot number | Aggregate Mix Number |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||