Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000762 DEA: 11430364 EFIS: 1118000109
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-79-20.2/53.0
Work Description: CULVERT REPAIR, GUARDRAIL, FLASHING BEACON AND SIGN REPLACEMENTS.
Location Description: SAN DIEGO COUNTY AT VARIOUS LOCATIONS FROM WEST JUNCTION ROUTE 78 TO RIVERSIDE COUNTY LINE
Contractor Name: NATIONWIDE CONTRACTING SERVICES, INC. DBA NATIONWIDE GENERAL CONSTRUCTION SERVICES
Contractor Address: 7660 Liberty Drive, Huntington Beach, CA 92647
Resident Engineer: Ryan Sresovich Structure Rep.: Unknown
DIME Sample ID: 2025-11-07-64
TL Number from the TL Form:
Sample Submitted By Organization: CT D11 - District 11 Materials Laboratory
Sample Organization Contact: (858) 518-8709
Type of Sample: Per Request
Type of Material: Hot Mix Asphalt
Sample Taken Date: 11/07/2025
Date that the sample was received by the laboratory/organization performing the testing: 11/10/2025
The quantity of what the sample constitutes: 4 Boxes
A brief description of the sample: Plant Sample
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Martin Marietta
HMA Type: Type A HMA
HMA Grading: 1/2 inch
Lot number:
Sublot number:
HMA Mix Number: 23417105 MM
Binder content (%): 5.3
Virgin binder PG: PG58-16
Design binder PG: PG58-16
Binder Supplier: Valero
RAP content (%): 0
WMA Additives: No
Antistrip type: Liquid
