Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-03-14-19
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214337 DEA: 080E33U4 EFIS: 0817000075 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-115-R7.3/R10.0 |
| Award Date | 04/26/2021 |
| Closeout Date | Not set |
| Work Description | ADD WB AUX & EB DECEL LANES, WIDEN I15 SW CONNECT,RAMPS/BRDG |
| Location Description | SAN BERNARDINO COUNTY IN ONTARIO FROM 0.2 MILE WEST OF CUCAMONGA CREEK BRIDGE TO MILLIKEN AVENUE |
| QA Service Level | 1 (Verified on 06/23/2021) |
Sample Information
| Sample Taken Date | 03/14/2023 | Sample Unique Key | 19 |
|---|---|---|---|
| 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 | 04/07/2023 |
| Sample type | Verification | A brief description of the sample | JMA 3/4" HMA-A-SP R15 No LAS |
| The quantity of what the sample constitutes | 4 Bags Of Agg., 2 Bags Of Rap | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | QC | Last name of sampler or witnessed by | Tech |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0196A-23 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | All American Asphalt- Corona | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-33-0005 |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | The fabricator/manufacturer designation for the sample | ||
| The plant number | A detailed description of where the material sample was collected | Belt Cut at All American Corona Plant | |
| Where the material sample would have been placed if not sampled | Asphalt Paving | Primary Aggregate Nominal Size | 3/4 inch |
| The concrete mix design number | 105927 | Lot number | |
| Sublot number | Aggregate Mix Number |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||