Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2022-09-06-74

Project Information

Project IdentifiersProject ID: 993418
DEA: 07324404
EFIS: 0716000077
DIST-CO-RTE-PM07-LA-22-0.0/1.5
Award Date02/18/2022
Closeout Date09/24/2024
Work DescriptionPLACE RHMA-G AND MODIFY SIGNAL AND LIGHTING SYSTEM.
Location DescriptionLOS ANGELES COUNTY IN LONG BEACH FROM ROUTE 1 TO SAN GABRIEL RIVER UNDERCROSSING
QA Service Level1 (Verified on 12/06/2021)

Sample Information

Sample Taken Date09/06/2022 Sample Unique Key74
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 testing09/19/2022
Sample typeVerification A brief description of the sampleHi-Natural
The quantity of what the sample constitutes1 Bag Hi-Nat From where was the sample collectedManufacturer
First name of sampler or witnessed byVictor Last name of sampler or witnessed byPham
Title of sampler Telephone number of sampler
Laboratory sample identification0643G-22 Linked DIME Sample ID
The fabricator/manufacturer/facility nameBlue Diamond Material-Irwindale Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeCrumb Rubber Modifier CRM TypeHigh Natural
Crumb Rubber Modifier Mix Number

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments