Sample Record for 2026-04-03-10
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000541 DEA: 09374704 EFIS: 0918000019
QA Service Level: 1
DIST-CO-RTE-PM: 09-INY-168,395-17.6/18.3,114.9/117.8
Work Description: HMA (TYPE A), MINOR CONCRETE, AND LIGHTING.
Location Description: INYO COUNTY IN AND NEAR BISHOP ON ROUTE 395 FROM 0.1 MILE SOUTH OF JAY STREET TO BARLOW LANE AND ON ROUTE 168 FROM PIONEER LANE TO ROUTE 395
Contractor Name: PAPICH CONSTRUCTION COMPANY, INC.
Contractor Address: P.O. BOX 2210, PISMO BEACH, CA 93448-2210
Resident Engineer: Matthew Gonzalez Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2026-04-03-10
TL Number from the TL Form:
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 04/03/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/03/2026
The quantity of what the sample constitutes: 500 tons
A brief description of the sample: 3/4" Class II AB
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Rock
Material Information
Source Identification (SMARA, name of Pit or Job Site): Jobsite
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: STA 159+58 / 159+82
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
