*Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Sample Record for 2019-12-18-14
Project ID: 99999 DEA: 0322222 QA Service Level:
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: Contractor Address:
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2019-12-18-14
TL Number from the TL Form: C671790
Sample Submitted By Organization: CT HQ - Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Acceptance
Type of Material: Soil
Sample Taken Date: 12/18/2019
Date that the sample was received by the laboratory/organization performing the testing: 12/19/2019
The quantity of what the sample constitutes: 1 day of production
A brief description of the sample: PG 64-16
From where was the sample collected: Other
Laboratory sample identification: AB196371
Structure unique identifier:
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: source
Where the material sample would have been placed if not sampled: