Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 55555 DEA: AMRL EFIS: AMRL
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for AASHTO Materials Reference Laboratory (AMRL).
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2025-05-12-59
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Proficiency
Type of Material: Asphalt Binder
Sample Taken Date: 05/12/2025
Date that the sample was received by the laboratory/organization performing the testing: 05/16/2025
The quantity of what the sample constitutes: PSP sample 280 B
A brief description of the sample: Sample 280 (B)
From where was the sample collected: Other
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AASHTO resource
Performance Grade: PG 58-16
Modified: No
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: AASHTO resource
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
