Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001686 DEA: 11430264 EFIS: 1118000083 COOP: NONE
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-94,188-15.2/65.3,0.0/1.9
Work Description: DRAINAGE RESTORATION, ADA CURB RAMPS & COMPLETE STREET.
Location Description: SAN DIEGO COUNTY ABOUT 6 MILES EAST OF LEMON GROVE ON ROUTE 94 FROM SWEETWATER RIVER BRIDGE TO AVENUE DE ROBLES VERDES NEAR MANZANITA AND ON ROUTE 188 FROM MEXICO BORDER NEAR TECATE TO ROUTE 94.
Contractor Name: LB Civil Construction
Contractor Address: 324 East Valley Parkway, Escondido, CA 92025
Resident Engineer: Daniel Assefa Structure Rep.: Unknown
DIME Sample ID: 2026-04-24-19
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: Verification
Type of Material: Hot Mix Asphalt
Sample Taken Date: 04/24/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/24/2026
The quantity of what the sample constitutes: 12 boxes
A brief description of the sample: JMFR
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Martin Marietta Lakeside
