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Sample Record for 2020-05-05-30

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: 2020-05-05-30
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: Quality Control
Type of Material: Asphalt Modifier
Sample Taken Date: 05/05/2020
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: enough for ATR to design
A brief description of the sample: Asphalt Modifer
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Tricor Refining

Material Information

Asphalt Modifier Type: For Rubberized Oil Designs
Asphalt Modifier Mix Number:

Test Results