Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000751 DEA: 060Y1704 EFIS: 0619000004
QA Service Level: 1
DIST-CO-RTE-PM: 06-KIN-41-0.0/15.5
Work Description: COLD PLANE AC PVMT, OVERLAY HMA AND RHMA.
Location Description: KINGS COUNTY NEAR KETTLEMAN CITY FROM THE KERN COUNTY LINE TO 0.8 MILE SOUTH OF ROUTE 5
Contractor Name: PAPICH CONSTRUCTION COMPANY, INC.
Contractor Address: Unknown
Resident Engineer: Oscar Sherrill Structure Rep.: Ramandeep Guraya
DIME Sample ID: 2025-06-26-41
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: Hot Mix Asphalt
Sample Taken Date: 06/26/2025
Date that the sample was received by the laboratory/organization performing the testing: 06/30/2025
The quantity of what the sample constitutes: 800 tons
A brief description of the sample: 3/4 HMA
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sierra Pacific - Avenal
