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: 2022-11-28-11
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: Hot Mix Asphalt
Sample Taken Date: 11/28/2022
Date that the sample was received by the laboratory/organization performing the testing: 10/21/2022
The quantity of what the sample constitutes: Solvent Prof.
A brief description of the sample: Sample 97 (A)
From where was the sample collected: Other
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AASHTO resource
