Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215003 DEA: 040J6204 EFIS: 0414000019
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-680-12.4/21.9
Work Description: REHABILITATE PAVEMENT - RPL APP/DEP SLABS, 14 BRIDGES
Location Description: ALAMEDA COUNTY AT SUNOL AND IN PLEASANTON AND DUBLIN FROM KOOPMANN ROAD UNDERCROSSING TO ALAMEDA COUNTY LINE
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 Townsgate Road, Suite 200, Westlake Village, CA 91361
Resident Engineer: Eddie Dike Structure Rep.: Betty Geng
DIME Sample ID: 2023-02-11-4
TL Number from the TL Form: 773070
Sample Submitted By Organization: CT D04 - Hayward Field Laboratory
Sample Organization Contact: (510) 723-0168
Type of Sample: Verification
Type of Material: Hot Mix Asphalt
Sample Taken Date: 02/11/2023
Date that the sample was received by the laboratory/organization performing the testing: 02/15/2023
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4 HMA + 15% RAP
From where was the sample collected: Job Site
Laboratory sample identification: HW-021123-AC1
Structure unique identifier:
Structure name: Route 680 NB
The fabricator/manufacturer/facility name: Martin Marietta Sunol Plant
