Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001223 DEA: 070W2104 EFIS: 0721000087
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-2-R18.7
Work Description: PLACE CLASS 3 AGGREGATE BASE AND HOT MIX ASPHALT.
Location Description: LOS ANGELES COUNTY IN LOS ANGELES AT LOS ANGELES REGIONAL TRANSPORTATION MANAGEMENT CENTER AT 2901 AT WEST BROADWAY
Contractor Name: SPLICE CONSTRUCTION CO, INC.
Contractor Address: 288441 Rancho De Linda, Laguna Niguel, CA 92677
Resident Engineer: Abdulraouf Daaboul Structure Rep.: Unknown
DIME Sample ID: 2025-09-14-7
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: 09/14/2025
Date that the sample was received by the laboratory/organization performing the testing: 09/19/2025
The quantity of what the sample constitutes: 20 BX HMA, 6 BGS CMB AGG 2 BGS RAP 4 QTS PG58-16 1 QT EVO
A brief description of the sample: 1/2" WMA A SP R25 .25% EVO
From where was the sample collected: Manufacturer
Laboratory sample identification: 0594A-25
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Sun Valley
