Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000538 DEA: 042Q6104 EFIS: 0419000030
QA Service Level: 1
DIST-CO-RTE-PM: 04-NAP-29-R7.3/13.5
Work Description: COLD PLANE, RHMA OVERLAY, INSTALL MGS, CURB RAMP, AND RUMBLE STRIP.
Location Description: NAPA COUNTY IN AND NEAR NAPA FROM 0.2 MILE NORTH OF NAPA RIVER BRIDGE OVERHEAD TO 0.1 MILE SOUTH OF SIERRA AVENUE.
Contractor Name: GRANITE ROCK COMPANY
Contractor Address: 2280 Bates Avenue, Suite 200, Concord, CA 94520
Resident Engineer: Paramdeep Brar Structure Rep.: Nana Budu
DIME Sample ID: 2025-07-17-102
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Hayward Field Laboratory
Sample Organization Contact: (510) 723-0168
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 07/17/2025
Date that the sample was received by the laboratory/organization performing the testing: 07/22/2025
The quantity of what the sample constitutes: 100Tons
A brief description of the sample: 3/8"HMA-R25-WMA
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Napa
