Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2024-04-08-68
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994147 DEA: 120R4104 EFIS: 1218000090 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-1-17.4/21.5 |
| Award Date | 09/27/2022 |
| Closeout Date | Not set |
| Work Description | COLD PLANE AC AND PLACE RHMA-G. |
| Location Description | ORANGE COUNTY IN NEWPORT BEACH FROM JAMBOREE ROAD TO SANTA ANA RIVER BRIDGE |
| QA Service Level | 1 (Verified on 06/28/2023) |
Sample Information
| Sample Taken Date | 04/08/2024 | Sample Unique Key | 68 |
|---|---|---|---|
| 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 | 04/09/2024 |
| Sample type | Verification | A brief description of the sample | 1 Bag Crumb Rubber Scrap |
| The quantity of what the sample constitutes | 1 Bag CRM Scrap | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | RJ Noble | Last name of sampler or witnessed by | QC |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0165G-24 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Vulcan-Corona/ Chandler Agg/ World ASP/ Ingevity | 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 | 49R003ARSPWEO |
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. | |||