Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994311 DEA: 080R1704 EFIS: 0812000028
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-40-R25.0/R50.0
Work Description: CONSTRUCT CSP, CSPA, SSPPA, STR CONC HW, IB, BFM, RSP, & MGS.
Location Description: SAN BERNARDINO COUNTY AT NEWBERRY SPRINGS AND LUDLOW FROM 1.6 MILES EAST OF FORT CADY ROAD OVERCROSSING TO CRUCERO ROAD UNDERCROSSING
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: Unknown
Resident Engineer: Thanh Pham Structure Rep.: Unknown
DIME Sample ID: 2024-11-06-34
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Barstow Field Laboratory 1
Sample Organization Contact: (760) 252-9216
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 11/06/2024
Date that the sample was received by the laboratory/organization performing the testing: 11/13/2024
The quantity of what the sample constitutes: 1 box, 2Cores
A brief description of the sample: 3/4" HMA-TYPE A
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Diamond-Victorville
