Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2021-08-20-40

Project Information

Project IdentifiersProject ID: 215587
DEA: 081L6804
EFIS: 0820000138
DIST-CO-RTE-PM08-RIV-91,15-7.5/13.4,8.2/23.9
Award DateNot set
Closeout DateNot set
Work DescriptionSLAB REPLACEMENT, PLACE SLURRY SEAL AND REPLACE AC SURFACING.
Location DescriptionRIVERSIDE 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 Level1 (Verified on 06/23/2021)

Sample Information

Sample Taken Date08/20/2021 Sample Unique Key40
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 testing09/09/2021
Sample typeVerification A brief description of the sampleJMF 3/4" WMA-A-SP R15, 0.4% Evotherm
The quantity of what the sample constitutes4 Bags of Combined Aggregate, 4 Bags of RAP From where was the sample collectedManufacturer
First name of sampler or witnessed byRMA Last name of sampler or witnessed byGroup
Title of sampler Telephone number of sampler
Laboratory sample identification0522A-21 Linked DIME Sample ID
The fabricator/manufacturer/facility nameAll American Asphalt Corona Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-33-0005
The fabricator's/manufacturer's product name for the sample3/4 WMA-A-SP R15 The fabricator/manufacturer designation for the sample
The plant number103793 A detailed description of where the material sample was collectedBelt Cut at All American Corona Plant
Where the material sample would have been placed if not sampledAsphalt Paving Primary Aggregate Nominal Size3/4 inch
The concrete mix design number Lot number
Sublot number JMF Verification ID

Submitted Tests

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