Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2024-04-25-34
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215349 DEA: 081C0824 EFIS: 0816000087 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-10-R104.9/R134.2 |
| Award Date | 03/24/2021 |
| Closeout Date | Not set |
| Work Description | PLACE HMA (TYPE A), JPCP AND IMPORTED BORROW. |
| Location Description | RIVERSIDE COUNTY FROM ROUTE 10/177 SEPARATION TO 1.1 MILES WEST OF WILEY'S WELL RD OC |
| QA Service Level | 1 (Verified on 03/01/2021) |
Sample Information
| Sample Taken Date | 04/25/2024 | Sample Unique Key | 34 |
|---|---|---|---|
| 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 | 04/30/2024 |
| Sample type | Verification | A brief description of the sample | Hi-Natural |
| The quantity of what the sample constitutes | 1 Bag Of Hi-Nat | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Kristopher | Last name of sampler or witnessed by | Matinez |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0205G-24 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Fisher Sand and Gravel-Tempe | 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 | High Natural |
|---|---|---|---|
| Crumb Rubber Modifier Mix Number | 529SKR |
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. | |||