Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2022-07-01-33
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Project Information
| Project Identifiers | Project ID: 993535 DEA: 081M1104 EFIS: 0821000078 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-215-10.0/17.2 |
| Award Date | 03/14/2022 |
| Closeout Date | 12/05/2022 |
| Work Description | HMA, COLD PLANE AC PAVEMENT, AND TRAFFIC STRIPE TAPE. |
| Location Description | SAN BERNARDINO COUNTY?FROM 0.1 MILE NORTH OF 27TH STREET TO 0.1 MILE SOUTH OF DEVORE ROAD |
| QA Service Level | 1 (Verified on 02/21/2022) |
Sample Information
| Sample Taken Date | 07/01/2022 | Sample Unique Key | 33 |
|---|---|---|---|
| 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 | 07/11/2022 |
| Sample type | Verification | A brief description of the sample | JMF 3/4" HMA-A-SP 0.50% LAS |
| The quantity of what the sample constitutes | 4 Bags Belt Cut Agg., | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Vulcan | Last name of sampler or witnessed by | QC |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0440A-22 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Vulcan-San Bernardino Portable | 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) | 91-19-0035, 91-36-0107 |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | The fabricator/manufacturer designation for the sample | ||
| The plant number | 224108 SBP SJR | A detailed description of where the material sample was collected | Belt Cut at Vulcan Materials-San Bernardino |
| 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. | |||