Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001120 DEA: 033G6204 EFIS: 0325000037
QA Service Level: 1
DIST-CO-RTE-PM: 03-YOL-5-R22.8/R28.9
Work Description: COLD PLANE AC PVMT AND HMA (TYPE A).
Location Description: YOLO COUNTY NEAR DUNNIGAN FROM 0.2 MILE NORTH OF ROUTE 505/5 SEPARATION TO THE COLUSA COUNTY LINE
Contractor Name: ALL-AMERICAN CONSTRUCTION, INC.
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2025-11-01-6
TL Number from the TL Form:
Sample Submitted By Organization: Blackburn Consulting
Sample Organization Contact: (916) 375-8706
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 11/01/2025
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 2 Boxes
A brief description of the sample: 3/4" HMA-SP w/ RAP, PG 64-16
From where was the sample collected: Manufacturer
Laboratory sample identification: 6014
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Woodland
