DIME - Test Summary

Summary for Test 2023-06-05-63-1

Test performed: CTM 208-September 2011

Project Identifiers	Project ID: 993547 DEA: 081G7204 EFIS: 0816000057 COOP: 081666 Permit Numbers: 0819AOP0691
DIST-CO-RTE-PM	08---
Award Date	12/30/2021
Closeout Date	Not set
Work Description	METS have reviewed the (Source Inspection Quality Management Plan) SIQMP, Rev1 submitted on behalf of The city of Lake Elsinore. We are glad to inform you that it significantly complies.
Location Description	Not set
QA Service Level	2 (Verified on 01/31/2022)

Sample Taken Date	06/05/2023	Sample Unique Key	63
Date that the sample was received by the laboratory/organization performing the testing	07/21/2023	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	Victor
Last name of sampler or witnessed by	Capacete	Title of sampler
Telephone number of sampler		Laboratory sample identification	0376G-23
Linked DIME Sample ID		The fabricator/manufacturer/facility name	All American Asphalt- Corona
Transportation Laboratory (TL) Number		Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier		Structure name
Bid Item	Not set

Material Type	Crumb Rubber Modifier	CRM Type	High Natural
Crumb Rubber Modifier Mix Number	106836

DIME Sample ID: 2023-06-05-63

DIME Test ID: 2023-06-05-63-1

Testing Lab: CT D08 - Fontana Southern Regional Laboratory

Test Method: CTM 208-September 2011: Method of Test for Apparent Specific Gravity of Fine Aggregates

Test Release Date: 2023-10-04

Input Type: Calculated

Tester's full name: Amir Behjati

Date of test: 07/22/2023

Specific Gravity: 1.16

General comments (publicly viewable) (Max 1000 characters):

Test was verified on 10/4/2023 ✔