Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2021-08-27-17
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Project Information
| Project Identifiers | Project ID: 214532 DEA: 07316904 EFIS: 0715000227 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-1,2,5,10-Various |
| Award Date | 01/24/2020 |
| Closeout Date | 08/24/2022 |
| Work Description | TUNNEL LIGHTING, MESSAGE SIGN SYSTEMS, RETAINING WALL & BUILDING WORK. |
| Location Description | LOS ANGELES COUNTY AT VARIOUS LOCATIONS |
| QA Service Level | 1 (Verified on 04/15/2020) |
Sample Information
| Sample Taken Date | 08/27/2021 | Sample Unique Key | 17 |
|---|---|---|---|
| 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 | 08/31/2021 |
| Sample type | Verification | A brief description of the sample | Crumb Rubber Scrap |
| 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 | Victor | Last name of sampler or witnessed by | Pham |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0510G-21 | Linked DIME Sample ID | 2021-08-27-13 |
| The fabricator/manufacturer/facility name | Blue Diamond Material-Irwindale | 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: 2021-08-27-17-1 CTM 385-November 2016 (Verified)
DIME Test ID: 2021-08-27-17-2 CTM 208-September 2011 (Verified)