Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995051 DEA: 023H6804 EFIS: 0218000006
QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-5-R28.8/R44.1
Work Description: PLACE RHMA, PAINT TRAFFIC STRIPE, & INSTALL FIBER OPTIC CABLE SYSTEM.
Location Description: SHASTA COUNTY ABOUT 6 MILES NORTH OF SHASTA LAKE CITY FROM PIT RIVER BRIDGE TO 1.2 MILES SOUTH OF DOG CREEK BRIDGE
Contractor Name: J.F. SHEA CONSTRUCTION, INC.
Contractor Address: 17400 CLEAR CREEK ROAD, REDDING, CA 96001
Resident Engineer: Kyle Higgins Structure Rep.: Unknown
DIME Sample ID: 2024-09-03-48
TL Number from the TL Form: 851381
Sample Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Sample Organization Contact: (530) 225-3194
Type of Sample: Production Start-Up
Type of Material: Reclaimed Asphalt Pavement
Sample Taken Date: 09/03/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/03/2024
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: RAP
From where was the sample collected: Manufacturer
Laboratory sample identification: D79703B
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The fabricator/manufacturer/facility name: J F Shea Construction Inc - Fawndale Rock and Asphalt - Redding CA
RAP Source: Fawndale Rock and Asphalt, Redding, CA
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