Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2021-08-20-40
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215587 DEA: 081L6804 EFIS: 0820000138 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-91,15-7.5/13.4,8.2/23.9 |
| Award Date | 04/30/2021 |
| Closeout Date | 08/16/2023 |
| Work Description | SLAB REPLACEMENT, PLACE SLURRY SEAL AND REPLACE AC SURFACING. |
| Location Description | RIVERSIDE COUNTY IN AND NEAR CORONA AND MURRIETA ON ROUTE 91 FROM ROUTE 15/91 SEPARATION TO 0.4 MILE EAST OF TYLER STREET AND ON ROUTE 15 FROM 1.5 MILES NORTH OF WINCHESTER ROAD TO NICHOLS ROAD |
| QA Service Level | 1 (Verified on 06/23/2021) |
Sample Information
| Sample Taken Date | 08/20/2021 | Sample Unique Key | 40 |
|---|---|---|---|
| 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 | 09/09/2021 |
| Sample type | Verification | A brief description of the sample | JMF 3/4" WMA-A-SP R15, 0.4% Evotherm |
| The quantity of what the sample constitutes | 4 Bags of Combined Aggregate, 4 Bags of RAP | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | RMA | Last name of sampler or witnessed by | Group |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0522A-21 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | All American Asphalt Corona | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-33-0005 |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | 3/4 WMA-A-SP R15 | The fabricator/manufacturer designation for the sample | |
| The plant number | 103793 | A detailed description of where the material sample was collected | Belt Cut at All American Corona Plant |
| Where the material sample would have been placed if not sampled | Asphalt Paving | Primary Aggregate Nominal Size | 3/4 inch |
| The concrete mix design number | Lot number | ||
| Sublot number | Aggregate Mix Number | Not set |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||