Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2019-01-28-12

Project Information

Project IdentifiersProject ID: 213078
DEA: 081G6204
EFIS: 0816000031
DIST-CO-RTE-PM08-RIV-10,86-Var
Award Date04/06/2018
Closeout Date05/10/2019
Work DescriptionCOLD PLANE, RHMA-G OVERLAY, REPLACE PRECAST SLAB AND LOCALIZED DIG-OUT
Location DescriptionIN RIVERSIDE COUNTY AT VARIOUS LOCATIONS
QA Service Level1 (Verified on 04/09/2018)

Sample Information

Sample Taken Date01/28/2019 Sample Unique Key12
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 testing01/29/2019
Sample typeQuality Assurance A brief description of the sampleProduction Start Up
The quantity of what the sample constitutes750 Tons From where was the sample collectedJob Site
First name of sampler or witnessed byCCA Last name of sampler or witnessed byQC
Title of samplerQC Telephone number of sampler
Laboratory sample identification0115G-19 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCCA Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeHot Mix Asphalt HMA TypeRHMA-G
HMA Grading3/4 inch Lot number1
Sublot number1 HMA Mix NumberNot set

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