Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993595 DEA: 042Q5504 EFIS: 0419000024
QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-12-7.9/14.1
Work Description: RHMA OVERLAY, REPLACE CULVERTS, BRIDGE RAILS, AND MEDIAN BARRIERS.
Location Description: SOLANO COUNTY NEAR SUISUN CITY FROM 0.2 MILE EAST OF LAWLER RANCH PARKWAY TO 0.5 MILE EAST OF SHILOH ROAD
Contractor Name: BAY CITIES PAVING & GRADING, INC.
Contractor Address: 1450 Civic Court B#400, Concord, CA 94520
Resident Engineer: Asadullah Sarwary Structure Rep.: Kambiz Kouchesfahani
DIME Sample ID: 2026-03-06-29
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Concord Field Laboratory
Sample Organization Contact: (510) 714-7019
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 03/06/2026
Date that the sample was received by the laboratory/organization performing the testing: 03/09/2010
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 1/2 " hma-wma
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Woodland
