Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2022-09-06-31
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993418 DEA: 07324404 EFIS: 0716000077 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-22-0.0/1.5 |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | PLACE RHMA-G AND MODIFY SIGNAL AND LIGHTING SYSTEM. |
| Location Description | LOS ANGELES COUNTY IN LONG BEACH FROM ROUTE 1 TO SAN GABRIEL RIVER UNDERCROSSING |
| QA Service Level | 1 (Verified on 12/06/2021) |
Sample Information
| Sample Taken Date | 09/06/2022 | Sample Unique Key | 31 |
|---|---|---|---|
| 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 | 09/19/2022 |
| Sample type | Verification | A brief description of the sample | Hi-Nat |
| The quantity of what the sample constitutes | 1 Bag Hi-Nat | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Victor | Last name of sampler or witnessed by | Pham |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0543G-22 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Belt Cut at Blue Diamond-Irwindale | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Crumb Rubber Modifier | CRM Type | High Natural |
|---|---|---|---|
| Crumb Rubber Modifier Mix Number | Not set |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-09-06-31-1 CTM 208-September 2011 (Verified)
DIME Test ID: 2022-09-06-31-2 CTM 385-November 2016 (Verified)