Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2024-09-16-58

Project Information

Project IdentifiersProject ID: 214697
DEA: 07307104
EFIS: 0714000213
DIST-CO-RTE-PM07-LA-101-32.8
Award DateNot set
Closeout DateNot set
Work DescriptionCONSTRUCT BRIDGE.
Location DescriptionLOS ANGELES COUNTY IN AND NEAR AGOURA HILLS FROM 0.1 MILE WEST OF LIBERTY CANYON ROAD UNDERCROSSING TO 0.6 MILE EAST OF PALO COMADO OVERCROSSING
QA Service Level1 (Verified on 07/12/2021)

Sample Information

Sample Taken Date09/16/2024 Sample Unique Key58
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 testing09/18/2024
Sample typeVerification A brief description of the sampleJMF 3/4" WMA-A-SP R25 0.50% EVO
The quantity of what the sample constitutes4 Bags of comb. agg., 2 bags of RAP From where was the sample collectedManufacturer
First name of sampler or witnessed byJohn Last name of sampler or witnessed byMeijah
Title of sampler Telephone number of sampler
Laboratory sample identification0483A-24 Linked DIME Sample ID
The fabricator/manufacturer/facility nameIngevity/ Valero/ Fish Canyon Irwindale/ Vulcan Sun Valley Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-19-0035
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 collectedBelt Cut at Vulcan Sun Valley Plant
Where the material sample would have been placed if not sampledAsphalt Paving Primary Aggregate Nominal Size3/4 inch
The concrete mix design number220200W SVA VLO Lot number
Sublot number Aggregate Mix Number

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments