Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2023-10-06-49

Project Information

Project IdentifiersProject ID: 214486
DEA: 080K1224
EFIS: 0815000244
DIST-CO-RTE-PM08-SBD-15-R28.6/37.5
Award DateNot set
Closeout DateNot set
Work DescriptionREHBILIATATE EXISTING MAINLINE AND RAMP PAVEMENT
Location DescriptionSAN BERNARDINO COUNTY IN HESPERIA AND VICTORVILLE FROM OAK HILL ROAD OVERCROSSING TO 0.1 MILE SOUTH OF BEAR VALLEY ROAD OVERCROSSING
QA Service Level1 (Verified on 06/23/2021)

Sample Information

Sample Taken Date10/06/2023 Sample Unique Key49
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 testing10/25/2023
Sample typeVerification A brief description of the samplePSUE 3/4" HMA-A-SP R25, 1.0% LSM
The quantity of what the sample constitutes2 Bags Comb. Agg, 8 Bags Bin Agg., 1 Bag Rap From where was the sample collectedManufacturer
First name of sampler or witnessed byBlue Diamond Last name of sampler or witnessed byQC
Title of sampler Telephone number of sampler
Laboratory sample identification0540A-23 Linked DIME Sample ID
The fabricator/manufacturer/facility nameBlue Diamond-Victorville 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)91-36-0046
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 Blue Diamond Victorville Plant
Where the material sample would have been placed if not sampledAsphalt Paving Primary Aggregate Nominal Size3/4 inch
The concrete mix design number300154-R25 LSM 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