Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 66667 DEA: JMFPP EFIS: 0019000043
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for JMF Prequalification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2020-05-04-25
TL Number from the TL Form:
Sample Submitted By Organization: Teichert Materials - Sacramento
Sample Organization Contact: (916) 386-6974
Type of Sample: Quality Control
Type of Material: Warm Mix Asphalt Technology
Sample Taken Date: 05/04/2020
Date that the sample was received by the laboratory/organization performing the testing: 05/04/2020
The quantity of what the sample constitutes: JMF Prequalification Program
A brief description of the sample: Aggregate Quality
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Mead West Vaco
Warm Mix Asphalt Technology Type: Additive Technology
Warm Mix Asphalt Technology Product Name: XL 9000 Cecabase
WMA Mix Number:
