Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
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
DIME Sample ID: 2025-10-21-3
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: Hot Mix Asphalt
Sample Taken Date: 10/21/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/21/2025
The quantity of what the sample constitutes: 0-750 Tons @350T
A brief description of the sample: 3/4" HMA Type A
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Jaxon Baker/ LeGrand
