Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214698 DEA: 120N8904 EFIS: 1214000130
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-133-8.3/M9.3
Work Description: CONSTRUCT AUXILIARY LANE.
Location Description: ORANGE COUNTY IN IRVINE FROM ROUTE 133/405 SEPARATION TO IRVINE CENTER DRIVE OVERCROSSING
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3200 Park Center Drive, Suite #200, Costa Mesa, CA 92626
Resident Engineer: Arezo Ghiam Structure Rep.: Michael Yee
DIME Sample ID: 2025-06-04-53
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: Production Start-Up
Type of Material: Hot Mix Asphalt
Sample Taken Date: 06/04/2025
Date that the sample was received by the laboratory/organization performing the testing: 06/11/2025
The quantity of what the sample constitutes: 24 BX HMA 4 QT PG58-16 4 BG CMB AGG 2 BG RAP
A brief description of the sample: 3/4" WMA A SP 0.25% EVO
From where was the sample collected: Manufacturer
Laboratory sample identification: 0350A-25
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Corona
