Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2024-08-12-27

Project Information

Project IdentifiersProject ID: 994147
DEA: 120R4104
EFIS: 1218000090
DIST-CO-RTE-PM12-ORA-1-17.4/21.5
Award Date09/27/2022
Closeout DateNot set
Work DescriptionCOLD PLANE AC AND PLACE RHMA-G.
Location DescriptionORANGE COUNTY IN NEWPORT BEACH FROM JAMBOREE ROAD TO SANTA ANA RIVER BRIDGE
QA Service Level1 (Verified on 06/28/2023)

Sample Information

Sample Taken Date08/12/2024 Sample Unique Key27
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 testing08/14/2024
Sample typeProduction Start-Up A brief description of the sample3/4" RHMA G SP .25% EVO
The quantity of what the sample constitutes20 BOXES RHMA, 3 BAGS COMB AGG, 1 BAG CRM, 1 BAG HN, 4 QTS VGN OIL, 4 QTS RB OIL, 1 QT EVO From where was the sample collectedManufacturer
First name of sampler or witnessed byRJ NOBLE Last name of sampler or witnessed byQC
Title of sampler Telephone number of sampler
Laboratory sample identification0399G-24 Linked DIME Sample ID
The fabricator/manufacturer/facility nameRJ Noble, Orange CA 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 TypeRHMA-G
HMA Grading3/4 inch Lot number
Sublot number HMA Mix Number49R003ARSPWEO

Submitted Tests

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