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Sample Record for 2023-10-27-41

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 214336 DEA: 07302404 EFIS: 0713000488 QA Service Level: 1
DIST-CO-RTE-PM: 07-VEN-101-37/40
Work Description: PADRE JUAN REHAB
Location Description: VEN 101
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 4820 McGrath Street, Suite 101, Ventura, CA 93003
Resident Engineer: Alfred Ira Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2023-10-27-41
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Verification
Type of Material: Crumb Rubber Modifier
Sample Taken Date: 10/27/2023
Date that the sample was received by the laboratory/organization performing the testing: 11/01/2023
The quantity of what the sample constitutes: 1 Qt. Of Scrap
A brief description of the sample: Scrap
From where was the sample collected: Manufacturer
Laboratory sample identification: 0560G-23
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Construction - Santa Paula

Material Information

CRM Type: Scrap Tire
Crumb Rubber Modifier Mix Number: 1556

Test Results

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
2023-10-27-41-1CTM 208-September 2011: Method of Test for Apparent Specific Gravity of Fine Aggregates11/01/2023Not scheduledSatish JainCT D08 - Fontana Southern Regional Laboratory
2023-10-27-41-2CTM 385-July 2022: Method of Test for Crumb Rubber Modifier (CRM)11/01/2023Not scheduledSatish JainCT D08 - Fontana Southern Regional Laboratory