Sample Record
Owner Lab
- CT - Southern Regional Laboratory
DIME Sample ID 2019-08-27-11
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 212011 DEA: 07252624 EFIS: 0700021272 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-5-R45.4/R61.2 |
| Award Date | 04/17/2017 |
| Closeout Date | 01/25/2021 |
| Work Description | REHABILITATE CONCRETE PAVEMENT. |
| Location Description | LOS ANGELES COUNTY IN LOS ANGELES AND AT CASTAIC FROM 0.2 MILE SOUTH OF ROUTE 14/5 SEPARATION TO 0.7 MILE NORTH OF PALOMAS WASH BRIDGE |
| QA Service Level | 1 (Verified on 05/03/2017) |
Sample Information
| Sample Taken Date | 08/27/2019 | Sample Unique Key | 11 |
|---|---|---|---|
| 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 | 08/30/2019 |
| Sample type | Verification | A brief description of the sample | 1/2 RHMA-G-SP |
| The quantity of what the sample constitutes | PSE 4 bags | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | John | Last name of sampler or witnessed by | Dong |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0510G-19 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | All American Asphalt Corona | 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 or name of Pit) | 91-33-0005::ALL AMERICAN ASPHALT |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | 1/2 RHMA-G-SP | The fabricator/manufacturer designation for the sample | 106836 |
| The plant number | Unknown | A detailed description of where the material sample was collected | Belt Cut at All American San Fernando Plant |
| Where the material sample would have been placed if not sampled | Unknown | Primary Aggregate Nominal Size | 1/2 inch |
| The concrete mix design number | Unknown | Lot number | Unknown |
| Sublot number | Unknown | JMF Verification ID |