Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215420 DEA: 060R2104 EFIS: 0614000058
QA Service Level: 1
DIST-CO-RTE-PM: 06-MAD-41-6.2/9.2
Work Description: FOR CONSTRUCTION ON STATE HIGHWAY IN MADERA COUNTY NEAR MADERA FROM 0.1 MILE NORTH OF AVENUE 15 TO 2.2 MILES NORTH OF FRIANT MADERA CANAL BRIDGE
Location Description: MADERA COUNTY NEAR MADERA FROM 0.1 MILE NORTH OF AVENUE 15 TO 2.2 MILES NORTH OF FRIANT MADERA CANAL BRIDGE
Contractor Name: CAL VALLEY CONSTRUCTION
Contractor Address: 5125 N. Gates Ave, Ste 102, Fresno, CA 93722
Resident Engineer: Ryan Wilson Structure Rep.: Ramandeep Guraya
DIME Sample ID: 2024-05-08-11
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Fresno Construction Field Office
Sample Organization Contact: (559) 243-3828
Type of Sample: Department Acceptance
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 05/08/2024
Date that the sample was received by the laboratory/organization performing the testing: 05/08/2024
The quantity of what the sample constitutes: Multiple Lanes
A brief description of the sample: Skid Test Request
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier: 41-0039
Structure name: Friant-Madera Canal Bridge
The fabricator/manufacturer/facility name: Cal Valley Construction