Sample Record for 2025-09-25-53
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000665 DEA: 081K4004 EFIS: 0819000031
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-15-3.5/6.8
Work Description: HMA (TYPE A), RDWY EXC, STR CONC RET WALL, RUBBERIZED HMA (OGFC).
Location Description: TEMECULA FROM 0.1 MI NORTH OF TEMECULA PARKWAY TO 0.2 MI NORTH OF WINCHESTER ROAD
Contractor Name: BEADOR CONSTRUCTION COMPANY, INC.
Contractor Address: 2900 Bristol Street, Suite D204, Costa Mesa, CA 92626
Resident Engineer: Denise Sostrom Structure Rep.: Gizachew Abayneh
Sample Information
DIME Sample ID: 2025-09-25-53
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: Verification
Type of Material: Aggregate
Sample Taken Date: 09/25/2025
Date that the sample was received by the laboratory/organization performing the testing: 09/30/2025
The quantity of what the sample constitutes: 4 Bags of Combined Aggregate, 2 Bags of RAP
A brief description of the sample: JMF Verification, 3/4" HMA A SP R25 .25% EVO
From where was the sample collected: Manufacturer
Laboratory sample identification: 0614A-25
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RJ Noble-Corona
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-33-0014
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Belt Cut at RJ Noble Corona Plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number: 36R2508SPWEC
Test Results
