Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995263 DEA: 061G3304 EFIS: 0624000029
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-180-118/138
Work Description: FRE 180 Emergency Slope Repairs.
Location Description:
Contractor Name: CAL VALLEY CONSTRUCTION
Contractor Address: 5125 N. Gates Ave, Ste 102, Fresno, CA 93722
Resident Engineer: Mark Mengoni Structure Rep.: Benjamin Holton
DIME Sample ID: 2024-04-11-31
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: Soil
Sample Taken Date: 04/11/2024
Date that the sample was received by the laboratory/organization performing the testing: 04/11/2024
The quantity of what the sample constitutes: 1 Bucket
A brief description of the sample: Class 2 Aggregate Subbase
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Sanger
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: pm 123.39 FG
Where the material sample would have been placed if not sampled:
DIME Test ID: 2024-04-11-31-1
Test Method: CTM 216-June 2011: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates
Submitted By Organization: CT D06 - Millbrook Field Laboratory
Organization Address: 3240 North Millbrook Avenue,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93726
Organization Email: tomas.silva@dot.ca.gov
Organization Phone: (559) 417-5341
Data has not been verified.
