Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212737 DEA: 060S8304 EFIS: 0615000046
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-5-44.4-45.4
Work Description: TUMEY GULCH ABUTMENT REHAB BR# 42-0246L/R.
Location Description: IN FRESNO COUNTY AT TUMEY GULCH.
Contractor Name: Bruce Shumacher
Contractor Address: 2716 S Granite Ct, Fresno, CA 93706
Resident Engineer: Cary Cruz Structure Rep.: Ben Holton
DIME Sample ID: 2023-08-16-19
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Millbrook Field Laboratory
Sample Organization Contact: (559) 417-5341
Type of Sample: Department Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 08/16/2023
Date that the sample was received by the laboratory/organization performing the testing: 08/16/2023
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4 HMA
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Coalinga
