Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212562 DEA: 024G5504 EFIS: 0214000036
QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-5-2.7/R11.4
Work Description: RECONSTRUCT WITH HMA AND PCC, WIDEN STRUCTURE AND UPGRADE RAILS
Location Description: SISKIYOU COUNTY IN AND NEAR DUNSMUIR FROM SACRAMENTO RIVER BRIDGE TO 0.6 MILE SOUTH OF NORTH MOUNT SHASTA UNDERPASS
Contractor Name: J.F. SHEA CONSTRUCTION
Contractor Address: P.O. BOX 494519, REDDING, CA 96049-4519
Resident Engineer: Nicole Mallory Structure Rep.: Andrew Osullivan
DIME Sample ID: 2018-06-15-15
TL Number from the TL Form: T101 C 897253
Sample Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Sample Organization Contact: (530) 225-3194
Type of Sample: Department Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 06/15/2018
Date that the sample was received by the laboratory/organization performing the testing: 06/20/2018
The quantity of what the sample constitutes: 1 boxs
A brief description of the sample: 3/4 HMA A 15rap PG64-16
From where was the sample collected: Manufacturer
Laboratory sample identification: D77455
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JF Shea Fawndale
DIME Test ID: 2018-06-15-15-1
Test Method: AASHTO T308-10: Standard Method of Test for Determining the Asphalt Binder Content of Hot Mix Asphalt (HMA) by the Ignition Method (Method A) (Asphalt Binder Content)
Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Organization Address: 1657 Riverside Drive,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: 530-225-3194
Data has not been verified.
