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Sample Record for 2019-01-24-10

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 66667 DEA: JMFPP EFIS: 0019000043 QA Service Level:
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

Sample Information

DIME Sample ID: 2019-01-24-10
TL Number from the TL Form:
Sample Submitted By Organization: Jaxon Enterprises - Deer Creek Rock & Asphalt
Sample Organization Contact: (559) 793-0903
Type of Sample: Preliminary
Type of Material: Hot Mix Asphalt
Sample Taken Date: 01/24/2019
Date that the sample was received by the laboratory/organization performing the testing: 01/24/2019
The quantity of what the sample constitutes: 50
A brief description of the sample: 3/4" Type A HMA
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Jaxon Enterprises

Material Information

HMA Type: Type A HMA
HMA Grading: 3/4 inch
Lot number: 0
Sublot number: 1
HMA Mix Number:

Test Results