Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 66665 DEA: BMD EFIS: BMD
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Balanced Mix Design (BMD) data for hot mix asphalt. UCPRC is collecting BMD data from the test track built for accelerated pavement testing
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2026-09-04-37
TL Number from the TL Form: 00
Sample Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Informational
Type of Material: Hot Mix Asphalt
Sample Taken Date: 09/04/2026
Date that the sample was received by the laboratory/organization performing the testing: 09/04/2026
The quantity of what the sample constitutes: 24 BOXES
A brief description of the sample: 1/2" HMA-A
From where was the sample collected: Job Site
Laboratory sample identification: 026-006
Structure unique identifier: 95-621
Structure name: 00
The fabricator/manufacturer/facility name: Teichert
