Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000912 DEA: 061G7704 EFIS: 0624000165
QA Service Level: 1
DIST-CO-RTE-PM: 06-KIN-5-16.6/26.7
Work Description: REMOVE AND REPLACE ASPHALT CONCRETE OVERLAY.
Location Description: KINGS COUNTY IN AND NEAR AVENAL FROM ROUTE 5/41 SEPARATION TO FRESNO COUNTY LINE
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: Unknown
Resident Engineer: Chantha Chap Structure Rep.: Unknown
DIME Sample ID: 2025-10-23-34
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Millbrook Field Laboratory
Sample Organization Contact: (559) 341-3953
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/23/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/24/2025
The quantity of what the sample constitutes: 0-750 Tons Produced
A brief description of the sample: 3/4” HMA Aggregate
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Coalinga
