Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2025-03-04-34
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 66667 DEA: JMFPP EFIS: 0019000043 |
|---|---|
| DIST-CO-RTE-PM | 59--- |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | Special project for submitting Sample information for JMF Prequalification Program. |
| Location Description | Not set |
| QA Service Level | NOT VERIFIED |
Sample Information
| Sample Taken Date | 03/04/2025 | 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 | 03/06/2025 |
| Sample type | Verification | A brief description of the sample | JMF 1/2'' RWMA G SP 0.25% EVO |
| The quantity of what the sample constitutes | 4 Bags Comb Agg, 1 can EA Crumb Rubber (Scrap and Hi-Nat) | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | CHRISTOPHER | Last name of sampler or witnessed by | LUCERO |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0154G-25 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Ingevity, SJR, Vulcan Corona /Irwindale, CRM | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-33-0027, 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 collected | Belt cut at Vulcan CORONA | |
| Where the material sample would have been placed if not sampled | Asphalt Paving | Primary Aggregate Nominal Size | 1/2 inch |
| The concrete mix design number | 326122 CORD SJR EVO 0.25% | Lot number | |
| Sublot number | Aggregate Mix Number |
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. | |||