Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2024-07-23-17

Project Information

Project IdentifiersProject ID: 995059
DEA: 081G6404
EFIS: 0816000046
DIST-CO-RTE-PM08-SBD-395-R4.0/49.0
Award Date10/25/2023
Closeout DateNot set
Work DescriptionREPLACE ASPHALT CONCRETE SURFACING, COLD PLANE AC PVMT AND RHMA.
Location DescriptionSAN BERNARDINO COUNTY AT VARIOUS LOCATIONS FROM ROUTE 15/395 SEPARATION TO 3.1 MILES NORTH OF ROUTE 58/395 SEPARATION
QA Service Level1 (Verified on 08/15/2023)

Sample Information

Sample Taken Date07/23/2024 Sample Unique Key17
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 testing07/24/2024
Sample typeVerification A brief description of the sample3/4" HMA-A-SP R25 1.0% LSM
The quantity of what the sample constitutes24 BOX HMA, 3 BAGS (3/4",3/8", 1/2"), 2 BAGS SAND, 3 BAGS COMB AGG, 2 BAGS RAP, 4 QTS PG58-16 From where was the sample collectedManufacturer
First name of sampler or witnessed byAlex Last name of sampler or witnessed bySamano
Title of sampler Telephone number of sampler
Laboratory sample identification0345A-24 Linked DIME Sample ID
The fabricator/manufacturer/facility nameBlue Diamond-Victorville Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeHot Mix Asphalt HMA TypeType A HMA
HMA Grading3/4 inch Lot number
Sublot number HMA Mix Number300154 R25 LSM

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Test File Attachments