Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 213631 DEA: 04270104 EFIS: 0412000131
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-580-R30.8/R41.5
Work Description: REPLACE SLABS, RESURFACE SHOULDER & RAMPS & CONSTRUCT MBGR & BARRIER
Location Description: ALAMEDA COUNTY FROM ROUTE 580/ROUTE 238 SEPARATION TO BOSTON AVENUE UNDERCROSSING.
Contractor Name: DeSilva Gates
Contractor Address: 11555 Dublin Boulevard, Dublin, CA 94568
Resident Engineer: Raif Rihani Structure Rep.: Unknown
DIME Sample ID: 2019-10-25-18
TL Number from the TL Form: C031455
Sample Submitted By Organization: CT D04 - Hayward Field Laboratory - Deactivated
Sample Organization Contact: (510) 385-7921
Type of Sample: Department Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/25/2019
Date that the sample was received by the laboratory/organization performing the testing: 10/25/2019
The quantity of what the sample constitutes: 622 tons
A brief description of the sample: 3/4" HMA "A" + 25% RAP
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: De Silva Gates Sunol
