Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2021-06-07-41
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Project Information
| Project Identifiers | Project ID: 215559 DEA: 112N0574 EFIS: 1119000079 |
|---|---|
| DIST-CO-RTE-PM | 11-IMP-86-L8.4/8.8 |
| Award Date | 04/22/2021 |
| Closeout Date | Not set |
| Work Description | COLD PLANE AND PAVE WITH STRESS ABSORBING MEMBRANE INTERLAYER AND HMA. |
| Location Description | IMPERIAL COUNTY IN EL CENTRO FROM 0.1 MILE EAST OF NORTH IMPERIAL AVENUE TO TRESHILL ROAD. |
| QA Service Level | 1 (Verified on 06/03/2021) |
Sample Information
| Sample Taken Date | 06/07/2021 | Sample Unique Key | 41 |
|---|---|---|---|
| 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 | 08/20/2021 |
| Sample type | Verification | A brief description of the sample | Scrap 5000 for Chip Seal |
| The quantity of what the sample constitutes | 1 Bag of Scrap Crumb Rubber | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Not Provided | Last name of sampler or witnessed by | Not Provided |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 4526 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Not Provided | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Crumb Rubber Modifier | CRM Type | Scrap Tire |
|---|---|---|---|
| Crumb Rubber Modifier Mix Number | Not set |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-06-07-41-1 CTM 385-November 2016 (Verified)
DIME Test ID: 2021-06-07-41-2 CTM 208-September 2011 (Verified)