Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001979 DEA: 031J1604 EFIS: 0320000113
QA Service Level: 1
DIST-CO-RTE-PM: 03-ED-50-35.1,39.7/58.9
Work Description: CAPM & Drainage Improvements
Location Description:
Contractor Name: GEORGE REED, INC.
Contractor Address: 1200 SCENIC DRIVE, SUITE 200, MODESTO, CA 95350
Resident Engineer: Brian Thompson Structure Rep.: Unknown
DIME Sample ID: 2026-07-09-30
TL Number from the TL Form:
Sample Submitted By Organization: Blackburn Consulting
Sample Organization Contact: (916) 375-8706
Type of Sample: Verification
Type of Material: Hot Mix Asphalt
Sample Taken Date: 07/09/2026
Date that the sample was received by the laboratory/organization performing the testing: 07/09/2026
The quantity of what the sample constitutes: 110 Tons
A brief description of the sample: 3/4" HMA-SP
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: George Reed Rio Linda
HMA Type: Type A HMA
HMA Grading: 3/4 inch
Lot number:
Sublot number:
HMA Mix Number: 2026RL34VSSE6428
Binder content (%): 4.6
Virgin binder PG: PG 64-28
Design binder PG: PG 64-28
Binder Supplier: VSSE
RAP content (%): 12
WMA Additives:
Antistrip type:
