Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2024-03-05-19
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994121 DEA: 120P68U4 EFIS: 1218000105 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-1-13.0/33.7 |
| Award Date | 07/12/2023 |
| Closeout Date | Not set |
| Work Description | COLD PLANE, PLACE RHMA AND MODIFY CURB RAMPS AND ELECTRICAL SYSTEMS. |
| Location Description | ORANGE COUNTY AT VARIOUS LOCATIONS FROM CRYSTAL HEIGHTS DRIVE TO LOS ANGELES/ORANGE COUNTY LINE |
| QA Service Level | 1 (Verified on 07/07/2023) |
Sample Information
| Sample Taken Date | 03/05/2024 | Sample Unique Key | 19 |
|---|---|---|---|
| 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 | 03/08/2024 |
| Sample type | Verification | A brief description of the sample | Crumb Rubber Scrap |
| The quantity of what the sample constitutes | 1 Bag Of Crumb Rubber Scrap | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Victor | Last name of sampler or witnessed by | Capacete |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0131G-24 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | All American Asphalt- Corona | 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 | 108835 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2024-03-05-19-1 CTM 208-September 2011 (Verified)
DIME Test ID: 2024-03-05-19-2 CTM 385-July 2022 (Verified)