Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002171 DEA: 101U0504 EFIS: 1025000085
QA Service Level: 1
DIST-CO-RTE-PM: 10-UNKNOWN--unknown
Work Description:
Location Description:
Contractor Name: George Reed Inc
Contractor Address: 1156 scenic Drive suite 200, Modesto, CA, 95350
Resident Engineer: Jonathon Ngai Structure Rep.: Unknown
DIME Sample ID: 2026-05-08-47
TL Number from the TL Form:
Sample Submitted By Organization: CT D10 - District 10 Materials Laboratory
Sample Organization Contact: (209) 948-7567
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 05/08/2026
Date that the sample was received by the laboratory/organization performing the testing: 05/11/2026
The quantity of what the sample constitutes: JMF 16 boxs plus Agg
A brief description of the sample: 1/2" HMA w/22% rap
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: GRI table Mtn
