Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212803 DEA: 060T8004 EFIS: 0615000231
QA Service Level: 1
DIST-CO-RTE-PM: 06-TUL-99-R37.3/41.3
Work Description: RESURFACE EXISTING PAVEMENT WITH RHMA-OPEN (BWC).
Location Description: TULARE COUNTY NEAR GOSHEN FROM 0.9 MILE SOUTH OF WEST VISALIA OVERHEAD TO 0.2 MILE NORTH OF NORTH GOSHEN OVERHEAD
Contractor Name: PAPICH CONSTRUCTION COMPANY, INC.
Contractor Address: Unknown
Resident Engineer: Structure Rep.: Unknown
DIME Sample ID: 2019-09-05-38
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: Dispute Resolution
Type of Material: Hot Mix Asphalt
Sample Taken Date: 09/05/2019
Date that the sample was received by the laboratory/organization performing the testing: 10/01/2019
The quantity of what the sample constitutes: 2
A brief description of the sample: 1/2" RHMA OGFC
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Papich Construction
