Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214628 DEA: 031G6604 EFIS: 0319000116
QA Service Level: 1
DIST-CO-RTE-PM: 03-BUT-162-12.6/15.6
Work Description: COLD IN-PLACE RECYCLING, RHMA-G OVERLAY, AND COLD PLANE AC PAVEMENT.
Location Description: BUTTE COUNTY IN AND NEAR OROVILLE FROM 0.8 MILE EAST OF WILBUR ROAD TO FEATHER RIVER BRIDGE
Contractor Name: LAMON CONSTRUCTION
Contractor Address: 871 Von Geldern Way, Yuba City, California 95991
Resident Engineer: Ryan Johnson Structure Rep.: Unknown
DIME Sample ID: 2020-08-06-43
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Informational
Type of Material: Reclaimed Asphalt Pavement
Sample Taken Date: 08/06/2020
Date that the sample was received by the laboratory/organization performing the testing: 08/18/2020
The quantity of what the sample constitutes: 185 LF
A brief description of the sample: Recycled Plastic Binder RAP
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pavement Recycling Systems
RAP Source: EB US 162 Near Christian Ave Slab 3
Aggregate Size:
Aggregate Source:
RAP Stockpile: Continuous
Stockpile Size (tons):
Reclaimed Asphalt Pavement Mix Number:
