Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995026 DEA: 040Q1004 EFIS: 0418000044
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-580-20.7/30.8
Work Description: REHAB ALA 580
Location Description: ALAMEDA COUNTY IN PLEASANTON AND CASTRO VALLEY FROM ROUTE 680/580 SEPARATION TO ROUTE 580/238 SEPARATION
Contractor Name: FBD VANGUARD CONSTRUCTION, INC.
Contractor Address: 550 Greenville Road, Livermore, CA 94550
Resident Engineer: Paramjit Pandher Structure Rep.: John Parecadan
DIME Sample ID: 2025-08-22-69
TL Number from the TL Form: PL-082225-1
Sample Submitted By Organization: CT D04 - Hayward DME / District Laboratory
Sample Organization Contact: (510) 507-3456
Type of Sample: Production Start-Up
Type of Material: Hot Mix Asphalt
Sample Taken Date: 08/22/2025
Date that the sample was received by the laboratory/organization performing the testing: 09/05/2025
The quantity of what the sample constitutes: 14 Boxes of RHMA-G
A brief description of the sample: 1/2"RHMA-G
From where was the sample collected: Source
Laboratory sample identification: D04-SE-25-056
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Pleasanton
