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Sample Record for 2022-09-19-1

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

Project Information

DEA: No Project QA Service Level:
DIST-CO-RTE-PM: ---
Work Description: Special project identifier for material not associated with a project
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2022-09-19-1
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: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 09/19/2022
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: 1
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: 1

Material Information

HMA Type: Type A HMA
HMA Grading: 1 inch
Lot number:
Sublot number:
HMA Mix Number:

Test Results