Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2024-06-20-99
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 995059 DEA: 081G6404 EFIS: 0816000046 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-395-R4.0/49.0 |
| Award Date | 10/25/2023 |
| Closeout Date | Not set |
| Work Description | REPLACE ASPHALT CONCRETE SURFACING, COLD PLANE AC PVMT AND RHMA. |
| Location Description | SAN BERNARDINO COUNTY AT VARIOUS LOCATIONS FROM ROUTE 15/395 SEPARATION TO 3.1 MILES NORTH OF ROUTE 58/395 SEPARATION |
| QA Service Level | 1 (Verified on 08/15/2023) |
Sample Information
| Sample Taken Date | 06/20/2024 | Sample Unique Key | 99 |
|---|---|---|---|
| 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 | 06/24/2024 |
| Sample type | Verification | A brief description of the sample | Hi-Nat |
| The quantity of what the sample constitutes | 1 Bag of Hi-Natural | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Idris | Last name of sampler or witnessed by | Nazzar |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 0302G-24 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Blue Diamond-Victorville | 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 |
|---|---|---|---|
| Crumb Rubber Modifier Mix Number | 300072 LSM |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2024-06-20-99-1 CTM 208-September 2011 (Verified)
DIME Test ID: 2024-06-20-99-2 CTM 385-July 2022 (Verified)