Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2019-06-10-4

Project Information

Project IdentifiersProject ID: 214004
DEA: 074W2704
EFIS: 0718000102
DIST-CO-RTE-PM07-VEN-101-8.9/11.5
Award Date04/22/2019
Closeout DateNot set
Work DescriptionPLACE RHMA-G (BONDED WEARING COURSE).
Location DescriptionVENTURA COUNTY IN THOUSAND OAKS AND CAMARILLO FROM 1.1 MILE WEST OF WENDY DRIVE OVERCROSSING TO ARROYO CONEJO BRIDGE
QA Service Level1 (Verified on 07/15/2019)

Sample Information

Sample Taken Date06/10/2019 Sample Unique Key4
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 testing06/11/2019
Sample typeVerification A brief description of the sample1/2 RHMA-G-BWC
The quantity of what the sample constitutesJMF 6 bags From where was the sample collectedManufacturer
First name of sampler or witnessed byKevin Granite Santa Paula Last name of sampler or witnessed byWilliam
Title of sampler Telephone number of sampler
Laboratory sample identification0341G-19 Linked DIME Sample ID
The fabricator/manufacturer/facility nameGranite Littlerock 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 or name of Pit)91-19-0008::LITTLEROCK
The fabricator's/manufacturer's product name for the sample1/2 RHMA-G BWC The fabricator/manufacturer designation for the sample1346
The plant numberUnknown A detailed description of where the material sample was collectedBelt Cut at Plant
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size1/2 inch
The concrete mix design numberUnknown Lot numberUnknown
Sublot numberUnknown JMF Verification ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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