Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-05-17-74
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214573 DEA: 073096U4 EFIS: 0719000091 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-210-R0.0/R9.7 |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | PLACE CONCRETE PAVEMENT, BARRIER, HMA, DRAINAGE, AND ELECTRICAL. |
| Location Description | LOS ANGELES COUNTY IN LOS ANGELES FROM INTERSTATE 5 TO WHEATLAND AVENUE UNDERCROSSING |
| QA Service Level | 1 (Verified on 06/05/2020) |
Sample Information
| Sample Taken Date | 05/17/2023 | Sample Unique Key | 74 |
|---|---|---|---|
| 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 | 06/01/2023 |
| Sample type | Verification | A brief description of the sample | 1 Bag of Hi-Natural |
| The quantity of what the sample constitutes | 1 Bag of Hi-Natural Crumb Rubber | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Thomas | Last name of sampler or witnessed by | Shivens QC |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0286G-23 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Vulcan Materials Sun Valley | 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 | High Natural |
|---|---|---|---|
| Crumb Rubber Modifier Mix Number | 326120 SVA3 LTR |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2023-05-17-74-1 CTM 208-September 2011 (Verified)
DIME Test ID: 2023-05-17-74-2 CTM 385-November 2016 (Verified)