Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2024-02-23-12
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994397 DEA: 073393U4 EFIS: 0722000031 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-605-R11.4/R19.5 |
| Award Date | 02/14/2023 |
| Closeout Date | Not set |
| Work Description | CONSTRUCT DPPIA DEVICES AND MODIFY LIGHTING SYSTEMS. |
| Location Description | LOS ANGELES COUNTY AT VARIOUS LOCATIONS FROM 0.1 MILE SOUTH OF SLAUSON AVENUE UNDERCROSSING TO 0.5 MILE NORTH OF VALLEY BOULEVARD UNDERCROSSING |
| QA Service Level | 1 (Verified on 07/13/2023) |
Sample Information
| Sample Taken Date | 02/23/2024 | 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 | 02/27/2024 |
| Sample type | Verification | A brief description of the sample | Scrap Crum Rubber |
| The quantity of what the sample constitutes | 1Bag Of Crum Rubber | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | G | Last name of sampler or witnessed by | Zubieta |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0124G-24 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | All American Asphalt-Irwindale | 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 | Scrap Tire |
|---|---|---|---|
| Crumb Rubber Modifier Mix Number | 106835 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2024-02-23-12-1 CTM 208-September 2011 (Verified)
DIME Test ID: 2024-02-23-12-2 CTM 385-November 2016 (Verified)