Sample Record for 2025-10-21-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000850 DEA: 061G8204 EFIS: 0624000169
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-33-46.8/47.4,53.4/61.4
Work Description: PARTIAL DEPTH RECYCLING AND HMA.
Location Description: FRESNO COUNTY IN AND NEAR MENDOTA FROM 0.4 MILE NORTH OF KAMM AVENUE TO MOUNTAIN VIEW AVENUE AND FROM ADAMS AVENUE TO BELMONT AVENUE
Contractor Name: ARCHER CIVIL CONSTRUCTION, LLC.
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2025-10-21-2
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Millbrook Field Laboratory
Sample Organization Contact: (559) 341-3953
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 10/21/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/20/2025
The quantity of what the sample constitutes: 0-750 Tons @ 350T
A brief description of the sample: 3/4 cold feed and rap
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Jaxon Baker/ LeGrand
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-24-0007
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: Conveyor Belt
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: 25-130
Lot number: 3
Sublot number: 1
Aggregate Mix Number: 25130
Test Results
