Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2022-04-05-8

Project Information

Project IdentifiersProject ID: 213707
DEA: 081C38U4
EFIS: 0817000196
DIST-CO-RTE-PM08-RIV-10-6.7/R25.1
Award DateNot set
Closeout DateNot set
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 Date04/05/2022 Sample Unique Key8
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 testing04/07/2022
Sample typeVerification A brief description of the sampleCorrection Factor, 3/4" HMA-A-SP R24 0.5% LAS
The quantity of what the sample constitutes4 Bags Of Aggregate, 1 Bag Rap From where was the sample collectedManufacturer
First name of sampler or witnessed byDavid Last name of sampler or witnessed byWalker
Title of sampler Telephone number of sampler
Laboratory sample identification0213A-22 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCalifornia Commercial Asphalt - Coachella 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)91-33-0084
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number43417615 A detailed description of where the material sample was collectedBelt Cut at California Commercial Asphalt Coachella
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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