Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2021-05-17-18

Project Information

Project IdentifiersProject ID: 213746
DEA: 080Q75U4
EFIS: 0817000114
DIST-CO-RTE-PM08-SBD,RIV-60-R4.6/R9.9, R0.0/12.2
Award Date04/18/2019
Closeout Date06/28/2022
Work DescriptionREPLACEMENT OF TWO OUTSIDE LANES AND CONCRETE SLABS
Location DescriptionNot set
QA Service Level1 (Verified on 06/17/2019)

Sample Information

Sample Taken Date05/17/2021 Sample Unique Key18
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 testing05/19/2021
Sample typeAcceptance A brief description of the sample3/4" RHMA-G PG 64-16RB 0.5% LAS
The quantity of what the sample constitutes4 boxes RHMA From where was the sample collectedManufacturer
First name of sampler or witnessed byKevin Last name of sampler or witnessed byOluoha
Title of sampler Telephone number of sampler
Laboratory sample identification0290G-21 Linked DIME Sample ID
The fabricator/manufacturer/facility nameVulcan Corona Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeHot Mix Asphalt HMA TypeRHMA-G
HMA Grading3/4 inch Lot number
Sublot number 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