Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2021-11-15-33

Project Information

Project IdentifiersProject ID: 213707
DEA: 081C38U4
EFIS: 0817000196
DIST-CO-RTE-PM08-RIV-10-6.7/R25.1
Award Date11/26/2019
Closeout Date11/01/2023
Work DescriptionRemove concrete pavement and base, and place HMA and JPCP
Location DescriptionROUTE 10/60 SEPARATION IN BEAUMONT TO ROUTE 10/111 SEPARATION NEAR CABAZON.
QA Service Level1 (Verified on 01/09/2020)

Sample Information

Sample Taken Date11/15/2021 Sample Unique Key33
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 testing12/01/2021
Sample typeAcceptance A brief description of the sampleAsphalt Rubber Binder
The quantity of what the sample constitutes1 Quart Can From where was the sample collectedSupplier
First name of sampler or witnessed byRuben Last name of sampler or witnessed byLopez
Title of sampler Telephone number of sampler
Laboratory sample identification0656-21 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCCA-Lake Elsinore Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Rubber Binder Asphalt modifier supplier
Performance GradePG 64-16 Lot number
Sublot number Asphalt Rubber Binder Mix NumberNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments