Sample Record

Owner Lab

  • CT HQ - Sacramento Materials Management Branch Field Office

DIME Sample ID 2017-08-10-10

Project Information

Project IdentifiersProject ID: 99999
DEA: 0322222
DIST-CO-RTE-PM03-SAC,OMG-888,99,80-0.6-0.6
Award DateNot set
Closeout DateNot set
Work DescriptionTHIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location DescriptionTHIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
QA Service Level (Verified on 04/05/2013)

Sample Information

Sample Taken Date08/10/2017 Sample Unique Key10
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing08/18/2017
Sample typeQuality Control A brief description of the sample123
The quantity of what the sample constitutes123 From where was the sample collectedSource
First name of sampler or witnessed by123 Last name of sampler or witnessed by123
Title of samplerUnknown Telephone number of samplerUnknown
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility name123 Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAntistrip Additive Antistrip Type123
Antistrip Additive Mix NumberNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments