Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000007 DEA: 061F8304 EFIS: 0623000101
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-180-43.5/53.6
Work Description: COLD PLANE AC PAVEMENT, RHMA-G (BWC) AND HMA (TYPE A).
Location Description: FRESNO COUNTY NEAR KERMAN FROM GOLDENROD AVENUE TO BRAWLEY AVENUE
Contractor Name: CAL VALLEY CONSTRUCTION, INC.
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2024-09-25-106
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Dispute Resolution
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: 10/30/2024
The quantity of what the sample constitutes: 4 BOXES OF RHMA
A brief description of the sample: 1/2" RHMA G .05% LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0597G-24
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan - Madera
