Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2023-04-30-6

Project Information

Project IdentifiersProject ID: 215109
DEA: 081C8504
EFIS: 0813000047
DIST-CO-RTE-PM08-RIV-74-0.0/5.8
Award DateNot set
Closeout DateNot set
Work DescriptionROADWAY EXCAVATION, HOT MIX ASPHALT, AND STRUCTURAL SHOTCRETE WALLS.
Location DescriptionRIVERSIDE COUNTY NEAR LAKE ELSINORE FROM ORANGE COUNTY LINE TO MONTE VISTA STREET
QA Service Level1 (Verified on 02/24/2021)

Sample Information

Sample Taken Date04/30/2023 Sample Unique Key6
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 testing05/08/2023
Sample typeVerification A brief description of the samplePSUE 3/4" HMA-A-SP
The quantity of what the sample constitutes4 Bags of Agg., 2 Bags of RAP From where was the sample collectedManufacturer
First name of sampler or witnessed byEduardo Last name of sampler or witnessed byGomez
Title of sampler Telephone number of sampler
Laboratory sample identification0240A-23 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCalifornia Commercial Asphalt - Lake Elsinore Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-33-0098
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 collectedManufacturer
Where the material sample would have been placed if not sampledAsphalt Paving Primary Aggregate Nominal Size3/4 inch
The concrete mix design number53417615 Lot number
Sublot number Aggregate Mix Number

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments