Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 66669 DEA: JMF-DATA EFIS: JMF-DATA
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for storing JMF sample data
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2023-04-17-92
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Pleasanton Field Laboratory
Sample Organization Contact: (510) 224-6127
Type of Sample: Quality Control
Type of Material: Warm Mix Asphalt Technology
Sample Taken Date: 04/17/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/17/2023
The quantity of what the sample constitutes: 100%
A brief description of the sample: 1/2" RHMA-G
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Ingevity
Warm Mix Asphalt Technology Type: Additive Technology
Warm Mix Asphalt Technology Product Name: Evotherm M1
WMA Mix Number:
