Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994819 DEA: 060U4304 EFIS: 0616000033
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-184-8.5/11.6
Work Description: RESURFACE LANES AND SHOULDERS.
Location Description: KERN COUNTY IN AND NEAR BAKERSFIELD FROM 0.1 MILE NORTH OF EDISON HIGHWAY TO 0.1 MILE NORTH OF CHASE AVENUE
Contractor Name: Griffith Company
Contractor Address: 1128 Carrier Parkway Avenue, Bakersfield CA 93308
Resident Engineer: Amrit Brar Structure Rep.: Unknown
DIME Sample ID: 2024-05-15-19
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Bakersfield Field Laboratory
Sample Organization Contact: 661-549-8281
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 05/15/2024
Date that the sample was received by the laboratory/organization performing the testing: 05/15/2024
The quantity of what the sample constitutes: 10 boxes HMA type A, 2 bags of aggregate
A brief description of the sample: 1/2" HMA type A
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Griffith Edmonston
