Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
DEA: No Project
QA Service Level:
DIST-CO-RTE-PM: ---
Work Description: Special project identifier for material not associated with a project
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 1971-11-11-1
TL Number from the TL Form:
Sample Submitted By Organization: Stonemont Solutions, Incorporated
Sample Organization Contact: (970) 674-1148
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 11/11/1971
Date that the sample was received by the laboratory/organization performing the testing: 05/13/2026
The quantity of what the sample constitutes: belt
A brief description of the sample: supplier
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: colorado
