Sample Record
Owner Lab
- CT - Southern Regional Laboratory
DIME Sample ID 2021-03-11-2
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 214885 DEA: 080K1234 EFIS: 0815000242 |
|---|---|
| DIST-CO-RTE-PM | 08--- |
| Award Date | 06/03/2020 |
| Closeout Date | 04/08/2022 |
| Work Description | Not set |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 04/08/2022) |
Sample Information
| Sample Taken Date | 03/11/2021 | Sample Unique Key | 2 |
|---|---|---|---|
| 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 | 03/12/2021 |
| Sample type | Verification | A brief description of the sample | JMF 1" HMA-A-SP R15 1.0% LSM |
| The quantity of what the sample constitutes | 9 Bags of Agg., 2 Bags Of Limetreated Agg., 2 Bags of RAP | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Blue Diamond Materials Victorville | Last name of sampler or witnessed by | QC |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0158A-21 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Blue Diamond Materials | 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) | 91-36-0046, 91-36-0106 |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | 1 HMA-A-SP R15 | The fabricator/manufacturer designation for the sample | |
| The plant number | 300222 WM | A detailed description of where the material sample was collected | Belt Cut at Blue Diamond Victorville Plant |
| Where the material sample would have been placed if not sampled | Asphalt Paving | Primary Aggregate Nominal Size | 1 inch |
| The concrete mix design number | Lot number | ||
| Sublot number | JMF Verification ID |
Submitted Tests
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