Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2023-06-05-63

Project Information

Project IdentifiersProject ID: 993547
DEA: 081G7204
EFIS: 0816000057
COOP: 081666
Permit Numbers: 0819AOP0691
DIST-CO-RTE-PM08---
Award Date12/30/2021
Closeout DateNot set
Work DescriptionMETS have reviewed the (Source Inspection Quality Management Plan) SIQMP, Rev1 submitted on behalf of The city of Lake Elsinore. We are glad to inform you that it significantly complies.
Location DescriptionNot set
QA Service Level2 (Verified on 01/31/2022)

Sample Information

Sample Taken Date06/05/2023 Sample Unique Key63
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 testing07/21/2023
Sample typeVerification A brief description of the sampleHi-Natural
The quantity of what the sample constitutes1 Bag Of Hi-Nat From where was the sample collectedManufacturer
First name of sampler or witnessed byVictor Last name of sampler or witnessed byCapacete
Title of sampler Telephone number of sampler
Laboratory sample identification0376G-23 Linked DIME Sample ID
The fabricator/manufacturer/facility nameAll American Asphalt- Corona Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeCrumb Rubber Modifier CRM TypeHigh Natural
Crumb Rubber Modifier Mix Number106836

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2023-06-05-63-1CTM 208-September 2011: Method of Test for Apparent Specific Gravity of Fine AggregatesAmir Behjati, CT D08 - Fontana Southern Regional Laboratory07/22/2023Satish Jain
Yes
10/04/2023
2023-06-05-63-2CTM 385-November 2016: Method of Test for Crumb Rubber Modifier (CRM)Amir Behjati, CT D08 - Fontana Southern Regional Laboratory07/22/2023Satish Jain
Yes
10/04/2023

Sample File Attachments

File NameExtensionDate UploadedActions
No results found.

Test File Attachments


DIME Test ID: 2023-06-05-63-1 CTM 208-September 2011 (Verified)
DIME Test ID: 2023-06-05-63-2 CTM 385-November 2016 (Verified)