Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-10-11-116
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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 | 116 |
|---|---|---|---|
| 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 |
| 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 | 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 | Crumb Rubber Modifier | CRM Type | Scrap Tire |
|---|---|---|---|
| Crumb Rubber Modifier Mix Number | 106836 |
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. | |||