Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995450 DEA: 09368004 EFIS: 0917000011
QA Service Level: 1
DIST-CO-RTE-PM: 09-MNO-395-91.6/93.4
Work Description: HOT MIX ASPHALT (TYPE A), RAIL ELEMENT WALL, AND ROADWAY EXCAVATION.
Location Description: MONO COUNTY ABOUT 16 MILES NORTH OF BRIDGEPORT FROM BURCHAM FLAT ROAD TO 0.3 MILE SOUTH OF ROUTE 108
Contractor Name: PAPICH CONSTRUCTION COMPANY, INC.
Contractor Address: Unknown
Resident Engineer: raj bharathan Structure Rep.: Unknown
DIME Sample ID: 2024-10-01-46
TL Number from the TL Form:
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/01/2024
Date that the sample was received by the laboratory/organization performing the testing: 10/03/2024
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4" HMA-A-SP PG64-16 R25
From where was the sample collected: Source
Laboratory sample identification: HMA-1
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Solari Plant