Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000776 DEA: 044G7804 EFIS: 0413000178
QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-1-0.0/58.6
Work Description: CENTERLINE RUMBLE STRIP,SHOULDER WIDENING, AND THERMOPLASTIC STRIPING.
Location Description: SONOMA COUNTY AT VARIOUS LOCATIONS FROM MARIN COUNTY LINE TO MENDOCINO COUNTY LINE
Contractor Name: O.C. JONES & SONS, INC.
Contractor Address: Unknown
Resident Engineer: Harley Paulo Structure Rep.: Unknown
DIME Sample ID: 2025-08-18-109
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Petaluma Field Laboratory
Sample Organization Contact: (510) 385-6841
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 08/18/2025
Date that the sample was received by the laboratory/organization performing the testing: 08/18/2025
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4 HMA
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: BoDean
