Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2022-11-23-23
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993805 DEA: 070W1404 EFIS: 0721000062 |
|---|---|
| DIST-CO-RTE-PM | 07-VEN-1-4.4/9.7 |
| Award Date | 06/24/2022 |
| Closeout Date | Not set |
| Work Description | COLD PLACE AC PAVEMENT AND PLACE RHMA-G. |
| Location Description | VENTURA COUNTY FROM BIG SYCAMORE MAINTENANCE STATION AND PARK TO 0.2 MILE SOUTH OF GALLEGUAS GREEK BRIDGE |
| QA Service Level | 1 (Verified on 05/11/2022) |
Sample Information
| Sample Taken Date | 11/23/2022 | Sample Unique Key | 23 |
|---|---|---|---|
| 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 | 11/29/2022 |
| Sample type | Verification | A brief description of the sample | Hi-Natural |
| The quantity of what the sample constitutes | 1 Qt Hi-Nat | 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 | 0760G-22 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Vulcan Materials-Saticoy | 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 | 326122 SAT VLO |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-11-23-23-1 CTM 208-September 2011 (Verified)
DIME Test ID: 2022-11-23-23-2 CTM 385-November 2016 (Verified)