Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995262 DEA: 041Q4604 EFIS: 0418000279
QA Service Level: 1
DIST-CO-RTE-PM: 04-SCL-280-0/2.7
Work Description: RHMA-G SURFACING AND CONSTRUCT BRIDGE APPROACH.
Location Description: SANTA CLARA COUNTY IN SAN JOSE FROM ROUTE 280/680/101 SEPARATION TO 0.2 MILE WEST OF BIRD AVENUE OVERCROSSING
Contractor Name: O.C. JONES & SONS, INC.
Contractor Address: 1520 4th Street, Berkeley, CA 94710
Resident Engineer: Nim Patel Structure Rep.: Unknown
DIME Sample ID: 2025-09-04-100
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - San Jose Construction Field Laboratory
Sample Organization Contact: (510) 385-8171
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 09/04/2025
Date that the sample was received by the laboratory/organization performing the testing: 09/05/2025
The quantity of what the sample constitutes: LOT 1 SUBLOT 10
A brief description of the sample: 3/4"RHMA-G
From where was the sample collected: Source
Laboratory sample identification: SJ-090425-T209-L1SL10
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Martin Marietta Sunol Drier Drum Plant
