Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000481 DEA: 081C07U4 EFIS: 0824000168
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-74-27.5/34.3
Work Description: RUBBERIZED HMA, FIBER OPTIC CABLE SYSTEMS, AND COLD PLANE AC PAVEMENT.
Location Description: RIVERSIDE COUNTY AT AND NEAR ROMOLAND AND HOMELAND FROM BONNIE DRIVE TO WINCHESTER ROAD
Contractor Name: GRIFFITH COMPANY
Contractor Address: 12200 Bloomfield Avenue, Santa Fe Springs, CA 90670
Resident Engineer: Omar Sanchez Structure Rep.: Unknown
DIME Sample ID: 2026-07-31-44
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 07/31/2026
Date that the sample was received by the laboratory/organization performing the testing: 07/30/2026
The quantity of what the sample constitutes: 817.11
A brief description of the sample: 3/4" HMA-A
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Martin Mariatta
