Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002458 DEA: 09428604 EFIS: 0925000087
QA Service Level: 1
DIST-CO-RTE-PM: 09-UNKNOWN--unknown
Work Description:
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Daniel Enriquez Structure Rep.: Unknown
DIME Sample ID: 2026-09-02-58
TL Number from the TL Form:
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 09/02/2026
Date that the sample was received by the laboratory/organization performing the testing: 09/08/2026
The quantity of what the sample constitutes: 250 Tons
A brief description of the sample: 3/4" HMA Cores
From where was the sample collected: Job Site
Laboratory sample identification: CR-1
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Griffith Edmonston-Lebec
DIME Test ID: 2026-09-02-58-1
Test Method: AASHTO T269-14: Standard Method of Test for Percent Air Voids in Compacted Dense and Open Asphalt Mixtures (Air Void)
Verified Date: 09/11/2026
Date Tested: 09/09/2026
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
General Comments for this Test: Core 1 Density: CR1A=92.3%
Test Result Compliance: complies
Additional Comments When Verified:
