Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001360 DEA: 09374804 EFIS: 0918000020
QA Service Level: 1
DIST-CO-RTE-PM: 09-INY-395-115.0
Work Description: BUILDING WORK AND PLACE HMA (TYPE A).
Location Description: INYO COUNTY IN BISHOP AT THE DISTRICT OFFICE AT 500 SOUTH MAIN STREET
Contractor Name: BOWE CONTRACTORS INC.
Contractor Address: 609 Bailey Ct, Tehachapi, CA 93561
Resident Engineer: David Carruba Structure Rep.: Joe Pedroni
DIME Sample ID: 2026-05-27-2
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: Hot Mix Asphalt
Sample Taken Date: 05/27/2026
Date that the sample was received by the laboratory/organization performing the testing: 05/27/2026
The quantity of what the sample constitutes: 70 tons of HMA
A brief description of the sample: 3/4" HMA Type A
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite 5 Bridges Plant Bishop
