Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993333 DEA: 04264724 EFIS: 0419000068
QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-101-R20.8/27.1
Work Description: CIP BRIDGES, CONSTRUCT ROADWAY, RETAINING WALLS AND MODIFY ELECTRICAL.
Location Description: MARIN COUNTY IN AND NEAR NOVATO FROM 0.1 MILE SOUTH OF FRANKLIN AVENUE OVERHEAD TO 0.5 MILE SOUTH OF SAN ANTONIO CREEK BRIDGE
Contractor Name: GHILOTTI CONSTRUCTION CO. INC. (RILEY GENAZZI & JOSH SERAFINO)
Contractor Address: 246 GHILOTTI AVE., SANTA ROSA, CA 95407
Resident Engineer: Fabio La Serna Structure Rep.: Jeremy Light
DIME Sample ID: 2025-02-13-3
TL Number from the TL Form:
Sample Submitted By Organization: CT SC - 3672 - Fairfield
Sample Organization Contact: (510) 393-9778
Type of Sample: Acceptance
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 02/13/2025
Date that the sample was received by the laboratory/organization performing the testing: 02/13/2025
The quantity of what the sample constitutes: multiple lanes
A brief description of the sample: skid test
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier: 27-0090L
Structure name: Franklin Ave. OH
The fabricator/manufacturer/facility name: GCC
Pavement Surface Type: PCC (Portland Cement Concrete)
Type of Traffic Control Provided: Behind K-Rail/Barrier
DIST-CO-RTE: 04-MRN-R20.88
Direction of Travel: South
Post Mile: 20.88
Lanes to be Tested: Shoulder,Lane #1
Station:
