Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995085 DEA: 07322904 EFIS: 0716000059
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-27-0.0/18.6
Work Description: REMOVE EXISTING AC PAVEMENT & HMA OVERLAY.
Location Description: LOS ANGELES COUNTY IN AND NEAR LOS ANGELES FROM ROUTE 1 TO DEVONSHIRE STREET
Contractor Name: C. A. RASMUSSEN, INC.
Contractor Address: 28548 Livingston Ave, Valencia, CA 91355
Resident Engineer: Ravin Maru Structure Rep.: Unknown
DIME Sample ID: 2025-07-01-19
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: 07/01/2025
Date that the sample was received by the laboratory/organization performing the testing: 07/08/2025
The quantity of what the sample constitutes: 20 BX RHMA 4 QT PG64-16 4 QT RBR BLND 2 QT LAS 4 BG CMB AGG 2 BG EA HN & CRM RBR
A brief description of the sample: 1/2" RHMA G SP 0.5% LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0415G-25
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Irwindale
