Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995060 DEA: 081J2604 EFIS: 0818000012
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-215-R13.5/R19.5
Work Description: RHMA, REPLACE AC SURFACING, ROCK BLANKET, AND COMPOST.
Location Description: RIVERSIDE COUNTY IN MURRIETA AND MENIFEE FROM 1.0 MILE NORTH OF CLINTON KEITH ROAD TO 1.0 MILE NORTH OF NEWPORT ROAD
Contractor Name: MARTIN MARIETTA SAN DIEGO AGGREGATES LLC DBA ATP GENERAL ENGINEERING CONTRACTORS
Contractor Address: 4211 Ponderosa Avenue, Suite C, San Diego, CA 92123
Resident Engineer: Osama Abdalla Structure Rep.: Unknown
DIME Sample ID: 2025-05-08-21
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: Hot Mix Asphalt
Sample Taken Date: 05/08/2025
Date that the sample was received by the laboratory/organization performing the testing: 05/09/2025
The quantity of what the sample constitutes: 24 BX RHMA R QT RBR BLND 4 QT PG64-16 2 QT EVO 4 BG CMB AGG
A brief description of the sample: 3/4" RHMA G SP .25% EVO
From where was the sample collected: Manufacturer
Laboratory sample identification: 0282G-25
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RJ Noble-Corona
