Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000540 DEA: 051Q03U4 EFIS: 0524000192
QA Service Level: 1
DIST-CO-RTE-PM: 05-SLO,KER-46-60.3/60.8,0.0/0.4
Work Description: VERTICAL CURVE AND EXTEND EXISTING TRUCK CLIMBING LANE.
Location Description: SAN LUIS OBISPO AND KERN COUNTIES NEAR CHOLAME FROM 2.0 MILES EAST OF ANTELOPE ROAD TO 0.4 MILE EAST OF THE KERN COUNTY LINE.
Contractor Name: PAPICH CONSTRUCTION COMPANY, INC.
Contractor Address: Unknown
Resident Engineer: Andrew Borelli Structure Rep.: Unknown
DIME Sample ID: 2025-09-16-77
TL Number from the TL Form:
Sample Submitted By Organization: CT D05 - Whitley Gardens Field Laboratory
Sample Organization Contact: 805-540-9933
Type of Sample: Dispute Resolution
Type of Material: Hot Mix Asphalt
Sample Taken Date: 09/16/2025
Date that the sample was received by the laboratory/organization performing the testing: 09/16/2025
The quantity of what the sample constitutes: 630 Tons
A brief description of the sample: 6 boxes of HMA
From where was the sample collected: Job Site
Laboratory sample identification: 250916-L1SL2
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sierra Pacific Materials - Avenal
