Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000115 DEA: 060Y7604 EFIS: 0619000024
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-L5506,L5725-
Work Description: MODIFICATION OF ELECTRICAL SYSTEM.
Location Description: FRESNO COUNTY IN FRESNO AT THE WEST AVENUE MAINTENANCE STATION 1283 NORTH WEST AVENUE AND AT THE DISTRICT OFFICE 1352 WEST OLIVE AVENUE
Contractor Name: NENAD RADMANOVIC DBA RADMAN ELECTRIC
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2025-02-19-4
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Millbrook Field Laboratory
Sample Organization Contact: (559) 341-3953
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 02/19/2025
Date that the sample was received by the laboratory/organization performing the testing: 02/19/2025
The quantity of what the sample constitutes: 64 tons
A brief description of the sample: 1/2 HMA ColdFeed
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: vulcan materials
Source Identification (SMARA, name of Pit or Job Site): Vulcan Materials
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: Coldfeed Chute
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
