Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2023-05-15-82

Project Information

Project IdentifiersProject ID: 993631
DEA: 120S8904
EFIS: 1221000058
DIST-CO-RTE-PM12-ORA-1-R0.1/R1.0
Award Date05/02/2022
Closeout Date09/07/2023
Work DescriptionCOLD PLANE AC PAVEMENT AND PLACE RHMA.
Location DescriptionORANGE COUNTY IN DANA POINT AND SAN JUAN CAPISTRANO FROM ROUTE 5/1 SEPARATION TO SAN JUAN CREEK BRIDGE
QA Service Level1 (Verified on 03/21/2022)

Sample Information

Sample Taken Date05/15/2023 Sample Unique Key82
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 testing05/22/2023
Sample typeVerification A brief description of the samplePSUE 3/4" WMA-A-SP R25 0.25% EVO
The quantity of what the sample constitutes4 Bags of Agg., 1 Bag of RAP From where was the sample collectedManufacturer
First name of sampler or witnessed byPlant Last name of sampler or witnessed byQC
Title of sampler Telephone number of sampler
Laboratory sample identification0263A-23 Linked DIME Sample ID
The fabricator/manufacturer/facility nameRJ Noble - Orange 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)91-33-0035
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 collectedBelt Cut at RJ Noble Orange Plant
Where the material sample would have been placed if not sampledAsphalt Paving Primary Aggregate Nominal Size3/4 inch
The concrete mix design number36R2508SPWEO 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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Test File Attachments