Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993595 DEA: 042Q5504 EFIS: 0419000024
QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-12-7.9/14.1
Work Description: RHMA OVERLAY, REPLACE CULVERTS, BRIDGE RAILS, AND MEDIAN BARRIERS.
Location Description: SOLANO COUNTY NEAR SUISUN CITY FROM 0.2 MILE EAST OF LAWLER RANCH PARKWAY TO 0.5 MILE EAST OF SHILOH ROAD
Contractor Name: BAY CITIES PAVING & GRADING, INC.
Contractor Address: 1450 Civic Court B#400, Concord, CA 94520
Resident Engineer: Asadullah Sarwary Structure Rep.: Kambiz Kouchesfahani
DIME Sample ID: 2025-09-13-14
TL Number from the TL Form: CON-091325-1
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: 09/13/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/03/2025
The quantity of what the sample constitutes: 16 boxes of mix
A brief description of the sample: 3/4" HMA-SP + 15% RAP
From where was the sample collected: Manufacturer
Laboratory sample identification: D04-SE-25-069
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Woodland (BP)
