Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-10-28-12
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Project Information
| Project Identifiers | Project ID: 994869 DEA: 073237U4 EFIS: 0720000224 |
|---|---|
| DIST-CO-RTE-PM | 07-VEN-150-13.3/19 |
| Award Date | 03/27/2023 |
| Closeout Date | Not set |
| Work Description | PLACE HMA (TYPE A) AND COLD PLANE ASPHALT |
| Location Description | VENTURA COUNTY IN AND NEAR OJAI FROM BURNHAM ROAD TO GORHAM ROAD |
| QA Service Level | 1 (Verified on 06/26/2023) |
Sample Information
| Sample Taken Date | 10/28/2023 | Sample Unique Key | 12 |
|---|---|---|---|
| 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 | 10/31/2023 |
| Sample type | Verification | A brief description of the sample | JMF 3/4" HMA-A-SP R30 0.5% LAS |
| The quantity of what the sample constitutes | 4 Bags Of Comb. Agg. | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Chris | Last name of sampler or witnessed by | Hurtado |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0556A-23 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Vulcan- Saticoy | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | 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 collected | Belt Cut at Vulcan -Saticoy | |
| Where the material sample would have been placed if not sampled | Asphalt Paving | Primary Aggregate Nominal Size | 3/4 inch |
| The concrete mix design number | 220203E SAT LTR | Lot number | |
| Sublot number | Aggregate Mix Number |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||