Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2021-09-01-14

Project Information

Project IdentifiersProject ID: 215494
DEA: 081H4904
EFIS: 0817000059
DIST-CO-RTE-PM08-SBD-18-31.9/38.5
Award Date04/05/2021
Closeout DateNot set
Work DescriptionCOLD PLANE AC PAVEMENT AND OVERLAY WITH HMA (TYPE A).
Location DescriptionSAN BERNARDINO COUNTY FROM 0.1 MILE EAST OF HILLTOP CONNECTOR TO 0.5 MILE EAST OF SIBERIA CREEK TRAIL
QA Service Level1 (Verified on 07/06/2021)

Sample Information

Sample Taken Date09/01/2021 Sample Unique Key14
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 testing09/02/2021
Sample typeAcceptance A brief description of the sample3/4" HMA-A SP R12 0.75% LAS
The quantity of what the sample constitutes2 boxes HMA From where was the sample collectedManufacturer
First name of sampler or witnessed byMatich Last name of sampler or witnessed byQC
Title of sampler Telephone number of sampler
Laboratory sample identification0516A-21 Linked DIME Sample ID
The fabricator/manufacturer/facility nameMatich-Lytle Creek 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 TypeType A HMA
HMA Grading3/4 inch Lot number
Sublot number HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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