Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995445 DEA: 043W5204 EFIS: 0421000384
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-580,680,880-VAR
Work Description: PLACE POLYESTER CONCRETE OVERLAY AND REPLACE JOINT SEAL.
Location Description: ALAMEDA COUNTY AT VARIOUS LOCATIONS
Contractor Name: MYERS & SONS CONSTRUCTION, LLC
Contractor Address: 45 Morrison Avenue, Sacramento, CA 95838
Resident Engineer: Eddie Dike Structure Rep.: Unknown
DIME Sample ID: 2024-09-25-79
TL Number from the TL Form: C032290
Sample Submitted By Organization: CT D04 - Pleasanton Field Laboratory
Sample Organization Contact: (510) 224-6127
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 09/25/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/26/2024
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 1/2" HMA w/25% RAP
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Pleasanton
