Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2023-11-28-34

Project Information

Project IdentifiersProject ID: 214708
DEA: 07323904
EFIS: 0716000072
DIST-CO-RTE-PM07-VEN-1-21.3/28.4
Award Date03/27/2023
Closeout DateNot set
Work DescriptionCOLD PLANE AC, PLACE RUBBERIZED HOT MIX AS
Location DescriptionVENTURA COUNTY NEAR VENTURA FROM ROUTE 1/101 SEPARATION TO MOBIL PIER ROAD.
QA Service Level1 (Verified on 07/12/2021)

Sample Information

Sample Taken Date11/28/2023 Sample Unique Key34
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 testing12/01/2023
Sample typeProduction Start-Up A brief description of the sample3/4" HMA-A-SP R22, PG64-10, 0.50 LAS
The quantity of what the sample constitutes20 Boxes of HMA From where was the sample collectedManufacturer
First name of sampler or witnessed byAVO Last name of sampler or witnessed byKARAJIAN
Title of samplerQC Telephone number of sampler
Laboratory sample identification0591A-23 Linked DIME Sample ID
The fabricator/manufacturer/facility nameVulcan-Saticoy Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeHot Mix Asphalt HMA TypeType A HMA
HMA Grading3/4 inch Lot number
Sublot number HMA Mix Number220831 SAT SJR

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Test File Attachments