Sample Record for 2024-11-14-26
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214649 DEA: 07316004 EFIS: 0715000194
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-14-60.70
Work Description: REHABILITATION FOR THE ON/OFF RAMPS AND ADJACENT SHOULDERS. UPGRADING METAL BEAM GUARDRAILS, AC DIKES, SIGN PANELS, CURB RAMPS, TRAFFIC LOOPS DETECTORS, AND SOME OTHER HIGHWAY APPURTENANCES.
Location Description: ROUTE 14 FROM PALMDALE BLVD TO KERN COUNTRY LINE.
Contractor Name: Guy F. Atkinson Construction LLC
Contractor Address: 18201 Von Karman Ave, Suite 800, Irvine, CA 92612
Resident Engineer: James Shih Structure Rep.: Hossein Sabbagh
Sample Information
DIME Sample ID: 2024-11-14-26
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: Verification
Type of Material: Aggregate
Sample Taken Date: 11/14/2024
Date that the sample was received by the laboratory/organization performing the testing: 11/15/2024
The quantity of what the sample constitutes: 1 BAG OF EA (3/4, 1/2, 3/8, WASH DUST), 1 BAG RAP
A brief description of the sample: PSUE 3/4'' HMA-A-SP R15 0.50% LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0632A-24
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Fish Canyon-Irwindale/ PALMDALE QUARRY/ Morlife 5000/ VALERO
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-19-0020
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Belt cut at Vulcan Palmdale Plant
Where the material sample would have been placed if not sampled: Asphalt Paving
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: 221534 PAL VLO
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
