Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 55555 DEA: AMRL EFIS: AMRL
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for AASHTO Materials Reference Laboratory (AMRL).
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2019-01-02-4
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Proficiency
Type of Material: Reclaimed Asphalt Pavement
Sample Taken Date: 01/02/2019
Date that the sample was received by the laboratory/organization performing the testing: 01/02/2019
The quantity of what the sample constitutes: 1
A brief description of the sample: Proficiency Sample
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AASHTO resource
RAP Source: Unknown
Aggregate Size: Unknown
Aggregate Source: Unknown
RAP Stockpile:
Stockpile Size (tons): Unknown
Reclaimed Asphalt Pavement Mix Number:
DIME Test ID: 2019-01-02-4-1
Test Method: AASHTO T30-15: Standard Method of Test for Mechanical Analysis of Extracted Aggregate (Mechanical Analysis)
Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Organization Address: 5900 Folsom Boulevard, Room 225,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (916) 227-7302
Data has not been verified.
