Sample Record for 2024-04-15-51
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994944 DEA: 081J2304 EFIS: 0818000002
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-60-R1.0/12.0
Work Description: RAMP METERING SYSTEM, HMA (TYPE A), RDWY EXC, MOD SIGNAL & LTG SYSTEMS
Location Description: RIVERSIDE COUNTY IN AND NEAR JURUPA VALLEY AND RIVERSIDE AT VARIOUS LOCATIONS FROM WINEVILLE ROAD UNDERCROSSING TO 0.2 MILE WEST OF ROUTE 60/91 SEPARATION
Contractor Name: POWELL CONSTRUCTORS INC
Contractor Address: 8555 BANANA AVE, FONTANA, CA 92335
Resident Engineer: Mahfual Alam Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2024-04-15-51
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 04/15/2024
Date that the sample was received by the laboratory/organization performing the testing: 04/19/2024
The quantity of what the sample constitutes: 4 Bags of Comb. Agg, 2 Bags of RAP
A brief description of the sample: PSUE 3/4" HMA-A-SP R15
From where was the sample collected: Manufacturer
Laboratory sample identification: 0183A-24
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA-Corona/ SJR
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-33-0005
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: AAA- Corona
Where the material sample would have been placed if not sampled: Asphalt Paving
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: 105927
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
