DIME - Sample Record for DIME Sample ID 2022-10-03-3

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Sample Record

Owner Lab

CT D12 - Huntington Beach Field Laboratory

DIME Sample ID 2022-10-03-3

Project Information

Project Identifiers	Project ID: 993530 DEA: 120S8604 EFIS: 1221000055
DIST-CO-RTE-PM	12-ORA-39-0.0/3.2
Award Date	03/08/2022
Closeout Date	05/02/2023
Work Description	COLD PLANE AC PAVEMENT AND PLACE RHMA.
Location Description	ORANGE COUNTY IN HUNTINGTON BEACH FROM ROUTE 1 TO ELLIS AVENUE/MAIN STREET
QA Service Level	1 (Verified on 01/25/2022)

Sample Information

Sample Taken Date	10/03/2022	Sample Unique Key	3
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	10/03/2022
Sample type	Verification	A brief description of the sample	RWMA 1/2"
The quantity of what the sample constitutes	17 boxes of RWMA, 4 Bags Virgin Agg, Oil 2 Cans, W M Additives 1 Can	From where was the sample collected	Manufacturer
First name of sampler or witnessed by	Sam	Last name of sampler or witnessed by	Jamyari
Title of sampler		Telephone number of sampler
Laboratory sample identification	22-0984	Linked DIME Sample ID
The fabricator/manufacturer/facility name	AAA Irvine	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name

Material Information

Material Type	Warm Mix Asphalt Technology	Warm Mix Asphalt Technology Type	Additive Technology
Warm Mix Asphalt Technology Product Name		WMA Mix Number	108836

Submitted Tests

DIME Test ID	Test Method	Tester Name, Testing Lab	Date Tested	Submitted By	Verified?	Release Date	Test Comments	Actions
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Test File Attachments