Sample Record

Owner Lab

  • CT D05 - Field Laboratory

DIME Sample ID 2020-01-01-9

Project Information

Project IdentifiersProject ID: 213943
DEA: 051G5704
EFIS: 0515000049
DIST-CO-RTE-PM05-SLO-58-0.7/1.9
Award Date06/14/2019
Closeout Date05/06/2020
Work DescriptionCOLD PLANE AC, PLACE RHMA-G AND RECONSTRUCT CURB RAMPS.
Location DescriptionSAN LUIS OBISPO COUNTY AT SANTA MARGARITA FROM 0.7 MILE EAST OF ROUTE 101/58 SEPARATION TO J STREET
QA Service Level1 (Verified on 08/20/2019)

Sample Information

Sample Taken Date01/01/2020 Sample Unique Key9
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeQuality Control A brief description of the sampleCRM
The quantity of what the sample constitutes0 From where was the sample collectedManufacturer
First name of sampler or witnessed byMr Last name of sampler or witnessed byWitness
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample IDJMF3512-2020-156-G2214H830
The fabricator/manufacturer/facility nameCRM Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeCrumb Rubber Modifier CRM TypeHigh Natural
HMA Design ID JMF3512-2020-156-G2214H830

Test Card Drafts

Material TypeTest MethodSaved ByDate SavedActions
No drafts of tests saved for your Sample.