Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 211614 DEA: 033C3804 EFIS: 0300000458
QA Service Level: 1
DIST-CO-RTE-PM: 03-ED-50-75.4/77.3
Work Description: HOT MIX ASPHALT, ROADWAY EXCAVATION, AND SIGNAL AND LIGHTING
Location Description: EL DORADO COUNTY IN SOUTH LAKE TAHOE FROM NORTH JUNCTION ROUTE 89 TO TROUT CREEK BRIDGE
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 13170 TELFAIR AVENUE, SYLMAR, CA 91342
Resident Engineer: Jaret Montplaisir Structure Rep.: Alfredo Carranza
DIME Sample ID: 2018-10-03-30
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Per Request
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/03/2018
Date that the sample was received by the laboratory/organization performing the testing: 06/28/2019
The quantity of what the sample constitutes: 1
A brief description of the sample: AMRL Proficiency Sample
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AASHTO resource
DIME Test ID: 2018-10-03-30-1
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Organization Address: 5900 Folsom Boulevard, Room 225,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (916) 227-7302
Data has not been verified.
