Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-02-03-23
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214336 DEA: 07302404 EFIS: 0713000488 |
|---|---|
| DIST-CO-RTE-PM | 07-VEN-101-37/40 |
| Award Date | 11/17/2020 |
| Closeout Date | 09/24/2024 |
| Work Description | PADRE JUAN REHAB |
| Location Description | VEN 101 |
| QA Service Level | 1 (Verified on 02/26/2021) |
Sample Information
| Sample Taken Date | 02/03/2023 | 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 | 02/06/2023 |
| Sample type | Verification | A brief description of the sample | Hi-Natural |
| The quantity of what the sample constitutes | 1 Gallon Hi-Nat | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Avo | Last name of sampler or witnessed by | Karajian |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0137G-23 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Granite Construction - Santa Paula | 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 | 1556 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2023-02-03-23-1 CTM 208-September 2011 (Verified)
DIME Test ID: 2023-02-03-23-2 CTM 385-November 2016 (Verified)