Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-03-13-27
Project Information
Project Identifiers | Project ID: 213750 DEA: 120K0224 EFIS: 1214000097 |
---|---|
DIST-CO-RTE-PM | 12-ORA-5-14.5/17.1 |
Award Date | 03/05/2019 |
Closeout Date | Not set |
Work Description | South County Improvement Project (Phase 2 - Oso/Alicia) CONST BRIDGES, RW, SW, HMA PVMT, JPCP, DRAINAGE, AND ELECT SYSTEMS. |
Location Description | ORANGE COUNTY IN MISSION VIEJO AND LAGUNA HILLS FROM 0.7 MILE SOUTH OF OSO PARKWAY OVERCROSSING TO 0.3 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING |
QA Service Level | 1 (Verified on 04/15/2019) |
Sample Information
Sample Taken Date | 03/13/2023 | Sample Unique Key | 27 |
---|---|---|---|
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 | 04/18/2023 |
Sample type | Verification | A brief description of the sample | Hi-Natural |
The quantity of what the sample constitutes | 1 Bag of Hi-Natural | From where was the sample collected | Manufacturer |
First name of sampler or witnessed by | David | Last name of sampler or witnessed by | Nguyen |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | 0206G-23 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | All American Asphalt-Irvine | 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 | Scrap Tire |
---|---|---|---|
Crumb Rubber Modifier Mix Number | 108835 |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
---|---|---|---|
No results found. |
Test File Attachments
DIME Test ID: 2023-03-13-27-1 CTM 208-September 2011 (Verified)
DIME Test ID: 2023-03-13-27-2 CTM 385-November 2016 (Verified)