Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2021-06-07-42

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 215559
DEA: 112N0574
EFIS: 1119000079
DIST-CO-RTE-PM11-IMP-86-L8.4/8.8
Award DateNot set
Closeout DateNot set
Work DescriptionCOLD PLANE AND PAVE WITH STRESS ABSORBING MEMBRANE INTERLAYER AND HMA.
Location DescriptionIMPERIAL COUNTY IN EL CENTRO FROM 0.1 MILE EAST OF NORTH IMPERIAL AVENUE TO TRESHILL ROAD.
QA Service Level1 (Verified on 06/03/2021)

Sample Information

Sample Taken Date06/07/2021 Sample Unique Key42
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 testing08/20/2021
Sample typeVerification A brief description of the sampleHi-Nat 5500 for Chip Seal
The quantity of what the sample constitutes1 Bag of Hi-Natural Crumb Rubber From where was the sample collectedManufacturer
First name of sampler or witnessed byNot Provided Last name of sampler or witnessed byNot Provided
Title of sampler Telephone number of sampler
Laboratory sample identification4526 Linked DIME Sample ID
The fabricator/manufacturer/facility nameNot Provided 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
JMF Verification ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-06-07-42-1CTM 385-November 2016: Method of Test for Crumb Rubber Modifier (CRM)Danilo FerrerCT - Southern Regional Laboratory08/23/2021Michael Magana
Yes
08/24/2021% Fabric is 0.01%
2021-06-07-42-2CTM 208-September 2011: Method of Test for Apparent Specific Gravity of Fine AggregatesDanilo FerrerCT - Southern Regional Laboratory08/23/2021Michael Magana
Yes
08/24/2021