Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000602 DEA: 040K6404 EFIS: 0416000112
QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-80-15.9/30.2
Work Description: COLD PLANE, OVERLAY, MGS, RAMP METERING, LIGHTING AND SIGNAL.
Location Description: SOLANO COUNTY ON ROUTE 80 IN AND NEAR FAIRFIELD AND VACAVILLE AT VARIOUS LOCATIONS FROM 1.5 MILES EAST OF SUISUN VALLEY ROAD OVERCROSSING TO 0.8 MILE EAST OF LEISURE TOWN ROAD OVERCROSSING.
Contractor Name: O.C. JONES & SONS, INC.
Contractor Address: Unknown
Resident Engineer: Justen Tatum Structure Rep.: Unknown
DIME Sample ID: 2025-06-24-66
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Concord Field Laboratory
Sample Organization Contact: (510) 714-7019
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 06/24/2025
Date that the sample was received by the laboratory/organization performing the testing: 06/27/2025
The quantity of what the sample constitutes: 661.76Tons
A brief description of the sample: cores
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Woodland
