Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 99999 DEA: 0322222
QA Service Level:
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Michael Maksimovich Structure Rep.: Unknown
DIME Sample ID: 2017-12-19-8
TL Number from the TL Form: TL 326120
Sample Submitted By Organization: CT HQ - QAM Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7266
Type of Sample: Quality Control
Type of Material: Crumb Rubber Modifier
Sample Taken Date: 12/19/2017
Date that the sample was received by the laboratory/organization performing the testing: 12/19/2017
The quantity of what the sample constitutes: TEST Quantity
A brief description of the sample: TEST Antistrip
From where was the sample collected: Other
Laboratory sample identification: Lab 326120
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CRM
DIME Test ID: 2017-12-19-8-1
Test Method: CTM 385-November 2016: Method of Test for Sampling and Testing Crumb Rubber Modifier (CRM)
Verified Date: 12/19/2017
Date Tested: 12/19/2017
Submitted By Organization: CT HQ - QAM Sacramento Field Laboratory
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
CRM Gradation Type
|
High Natural
|
High Natural CRM gradation (% passing No. 10 sieve)
|
100 %
|
Wire in CRM
|
0 %
|
Fabric in CRM
|
0 %
|