Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994321 DEA: 040K1604 EFIS: 0416000044
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA,CC-80-R7.6/8.0,0.0/13.5
Work Description: CONSTRUCT RHMA, LIGHTING SYSTEM, AND CONCRETE BARRIER.
Location Description: ALAMEDA AND CONTRA COSTA COUNTIES IN ALBANY AND CROCKETT FROM 0.4 MILE SOUTH OF ALAMEDA COUNTY LINE TO 0.2 MILE SOUTH OF POMONA STREET
Contractor Name: Bay Cities Paving & Grading (Jeff Brandt)
Contractor Address: 1450 CIVIC CT, BLDG B #400, CONCORD, CA 94520
Resident Engineer: Wesley Morrison Structure Rep.: Alyssa Inocencio
DIME Sample ID: 2025-05-12-46
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Richmond Field Laboratory
Sample Organization Contact: (510) 231-7151
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 05/12/2025
Date that the sample was received by the laboratory/organization performing the testing: 05/13/2025
The quantity of what the sample constitutes: 3 Bags of Aggregates
A brief description of the sample: Batch Plant Aggs
From where was the sample collected: Fabricator
Laboratory sample identification: Rich_24_162
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: County Asphalt Martinez
