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: 2018-11-07-8
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Department Acceptance
Type of Material: Cable Yield Indicator
Sample Taken Date: 11/07/2018
Date that the sample was received by the laboratory/organization performing the testing: 12/03/2018
The quantity of what the sample constitutes: 300
A brief description of the sample: Red disc springs
From where was the sample collected: Source
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Cable Moore
