Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 88888 DEA: SMTL-STOCK EFIS: SMTL-STOCK
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for SMTL stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2016-02-24-9
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Sample Organization Contact: (562) 500-5861
Type of Sample: Annual Source Testing
Type of Material: Cementitious
Sample Taken Date: 02/24/2016
Date that the sample was received by the laboratory/organization performing the testing: 09/06/2016
The quantity of what the sample constitutes: 1 Bucket
A brief description of the sample: Type II Cement
From where was the sample collected: Source
Laboratory sample identification: CM165657
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Lehigh CUCC China
