Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-04-24-32
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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 | 04/24/2023 | Sample Unique Key | 32 |
|---|---|---|---|
| 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 | 04/27/2023 |
| Sample type | Verification | A brief description of the sample | CRM Scrap |
| The quantity of what the sample constitutes | 1 Qt Of CRM | 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 | 0218G-23 | 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 | Scrap Tire |
|---|---|---|---|
| Crumb Rubber Modifier Mix Number | 326124 SAT VLO |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2023-04-24-32-1 CTM 208-September 2011 (Verified)
DIME Test ID: 2023-04-24-32-2 CTM 385-November 2016 (Verified)