Sample Record
Owner Lab
- CT - Southern Regional Laboratory
DIME Sample ID 2022-01-06-47
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 214620 DEA: 07309304 EFIS: 0714000281 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-210,405,605-Various |
| Award Date | 03/18/2020 |
| Closeout Date | Not set |
| Work Description | REINFORCE STRUCTURAL CONCRETE BRIDGE AND PLACE RHMA SHOULDER PAVING. |
| Location Description | LOS ANGELES COUNTY AT VARIOUS LOCATIONS |
| QA Service Level | 1 (Verified on 04/15/2020) |
Sample Information
| Sample Taken Date | 01/06/2022 | Sample Unique Key | 47 |
|---|---|---|---|
| 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 | 01/18/2022 |
| Sample type | Per Request | A brief description of the sample | Asphalt Rubber Binder |
| The quantity of what the sample constitutes | 1 Quart Can | From where was the sample collected | Supplier |
| First name of sampler or witnessed by | AAA Irwindale QC | Last name of sampler or witnessed by | AAA Irwindale QC |
| Title of sampler | QC | Telephone number of sampler | |
| Laboratory sample identification | 0102-22 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | AAA-Irwindale | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Asphalt Rubber Binder | Asphalt modifier supplier | |
|---|---|---|---|
| Performance Grade | PG 64-16 | Lot number | |
| Sublot number | HMA Design ID |