Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002228 DEA: 051R7604 EFIS: 0524000115
QA Service Level: 1
DIST-CO-RTE-PM: 05-SLO-229-5.5/9.2
Work Description: RHMA-G overlay, asphalt rubber binder chip seal, & shoulder backing
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2026-08-24-37
TL Number from the TL Form:
Sample Submitted By Organization: CT D05 - Paso Robles Field Laboratory
Sample Organization Contact: 1 (209) 610-9363
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 08/24/2026
Date that the sample was received by the laboratory/organization performing the testing: 08/24/2026
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 1/2" RHMA-G DL
From where was the sample collected: Manufacturer
Laboratory sample identification: 260827-L1SL1
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Construction - Templeton Plant
