Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2024-04-30-24
Project Information
Project Identifiers | Project ID: 994147 DEA: 120R4104 EFIS: 1218000090 |
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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 | 04/30/2024 | Sample Unique Key | 24 |
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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 | 05/02/2024 |
Sample type | Verification | A brief description of the sample | Hi-Natural |
The quantity of what the sample constitutes | 1 Bag Of Hi-Nat | From where was the sample collected | Manufacturer |
First name of sampler or witnessed by | R J Noble | Last name of sampler or witnessed by | QC |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | 0211G-24 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | R J Noble -Orange | 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 | High Natural |
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Crumb Rubber Modifier Mix Number | 49R003ARSPWEO |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2024-04-30-24-1 CTM 208-September 2011 (Verified)
DIME Test ID: 2024-04-30-24-2 CTM 385-July 2022 (Verified)