Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000603 DEA: 051K4504 EFIS: 0518000209
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-R52.3/R56.1
Work Description: COLD PLANE AND RHMA/HMA ROADWAY AND BRIDGE, & REPLACE CULVERTS.
Location Description: SANTA BARBARA COUNTY NEAR BUELLTON FROM OLD COAST HIGHWAY TO 0.4 MILE SOUTH OF SANTA ROSA ROAD OVERCROSSING
Contractor Name: CALPORTLAND CONSTRUCTION
Contractor Address: Unknown
Resident Engineer: Jason Torres Structure Rep.: Cliff Raplogle
DIME Sample ID: 2026-05-05-21
TL Number from the TL Form:
Sample Submitted By Organization: CT D05 - Santa Barbara Field Laboratory
Sample Organization Contact:
Type of Sample: Acceptance
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 05/05/2026
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: Multiple Lanes
A brief description of the sample: Skid Testing
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CALPORTLAND
Pavement Surface Type: PCC (Portland Cement Concrete)
Type of Traffic Control Provided: Stationary Lane Closure
DIST-CO-RTE:
Direction of Travel:
Post Mile: 55.00
Lanes to be Tested: Lane #2
Station:
