Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2023-05-18-68

Project Information

Project IdentifiersProject ID: 993508
DEA: 070W1104
EFIS: 0721000059
DIST-CO-RTE-PM07-LA-210-R35.9/R52.2
Award Date04/04/2022
Closeout Date09/24/2024
Work DescriptionCOLD PLANE OVERLAY, INDIVIDUAL REPLACEMENT SLAB AND TRAFFIC STRIPING.
Location DescriptionLOS ANGELES COUNTY FROM HIGHLAND AVENUE UNDERCROSSING IN DUARTE TO SAN ANTONIO WASH BRIDGE IN CLAREMONT.
QA Service Level1 (Verified on 04/19/2022)

Sample Information

Sample Taken Date05/18/2023 Sample Unique Key68
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 testing05/25/2023
Sample typeVerification A brief description of the samplePSUE 3/4" HMA-A-SP R15 0.5% LAS
The quantity of what the sample constitutes2 Bags of Agg., 1 Bag of RAP From where was the sample collectedManufacturer
First name of sampler or witnessed byBaher Last name of sampler or witnessed byFakhoury
Title of sampler Telephone number of sampler
Laboratory sample identification0271A-23 Linked DIME Sample ID
The fabricator/manufacturer/facility nameVulcan Materials - Irwindale 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)91-19-0035
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 Vulcan Materials - Irwindale
Where the material sample would have been placed if not sampledAsphalt Paving Primary Aggregate Nominal Size3/4 inch
The concrete mix design number220831A IRW LTR 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