Sample Record for 2025-11-03-5
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 993798 DEA: 09366804 EFIS: 0916000021
QA Service Level: 1
DIST-CO-RTE-PM: 09-INY-395-117.3/117.9
Work Description: MEADOW FARMS ADA
Location Description: INYO COUNTY NEAR BISHOP FROM 0.1 MILE EAST OF SEE VEE LANE TO BARLOW LANE
Contractor Name: PAPICH CONSTRUCTION COMPANY, INC.
Contractor Address: P.O. BOX 2210, PISMO BEACH, CA 93448-2210
Resident Engineer: Adam Zumstein Structure Rep.: Mulugheta Belay
Sample Information
DIME Sample ID: 2025-11-03-5
TL Number from the TL Form:
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 11/03/2025
Date that the sample was received by the laboratory/organization performing the testing: 11/03/2025
The quantity of what the sample constitutes: 1 Bag of RAP
A brief description of the sample: 3/4” Aggregate
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite 5 Bridges Plant Bishop
Material Information
Source Identification (SMARA, name of Pit or Job Site): Granite 5 Bridges Road Plant
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: RAP 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:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2025-11-03-5-1 | AASHTO T30-25: Standard Method of Test for Mechanical Analysis of Extracted Aggregate (Mechanical Analysis) | 11/03/2025 | Not scheduled | Joshua Hubartt | CT D09 - Bishop Field Laboratory | | Derek Carrington |
149090
