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Sample Record for 2020-07-07-6

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:
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

Sample Information

DIME Sample ID: 2020-07-07-6
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Sample Organization Contact: (562) 500-5861
Type of Sample: Verification
Type of Material: Antistrip Additive
Sample Taken Date: 07/07/2020
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 1
A brief description of the sample: 12
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: qer

Material Information

Antistrip Type: N/A
Antistrip Additive Mix Number:

Test Results