Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993562 DEA: 070Q7404 EFIS: 0720000271
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA--71-22/23
Work Description: IN LA COUNTY AT 710 & WASHINGTON BLVD. ON RAMPS AND OFF RAMPS RAMP WORK 0.2' COLD PLANE & 0.2' RHMA-G OVERLAY – CATEGORY OF 201.121 MINOR PAVEMENT REHAB (CAPM)
Location Description: Co-Rte-Post: LA-71-22/23
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2022-02-05-22
TL Number from the TL Form: na
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Department Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 02/05/2022
Date that the sample was received by the laboratory/organization performing the testing: 02/11/2022
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4" hma - a220831 sva sjr
From where was the sample collected: Job Site
Laboratory sample identification: 22-0033
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA Irwindale
DIME Test ID: 2022-02-05-22-1
Test Method: AASHTO T275-07r12: Standard Method of Test for Bulk Specific Gravity (Gmb) of Compacted Asphalt Mixtures Using Paraffin-Coated Specimens (Bulk Specific Gravity)
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 407-6963
Data has not been verified.
