Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995059 DEA: 081G6404 EFIS: 0816000046
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-395-R4.0/49.0
Work Description: REPLACE ASPHALT CONCRETE SURFACING, COLD PLANE AC PVMT AND RHMA.
Location Description: SAN BERNARDINO COUNTY AT VARIOUS LOCATIONS FROM ROUTE 15/395 SEPARATION TO 3.1 MILES NORTH OF ROUTE 58/395 SEPARATION
Contractor Name: SULLY-MILLER CONTRACTING COMPANY
Contractor Address: 135 S State College Blvd, Brea, Ca 92821
Resident Engineer: Shaun Loza Structure Rep.: Unknown
DIME Sample ID: 2024-06-18-2
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: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 06/18/2024
Date that the sample was received by the laboratory/organization performing the testing: 06/18/2024
The quantity of what the sample constitutes: 8 BOXES OF HMA
A brief description of the sample: 3/4" HMA-A-SP R15 1.0% LSM
From where was the sample collected: Manufacturer
Laboratory sample identification: 0295A-24
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Diamond-Victorville
DIME Test ID: 2024-06-18-2-1
Test Method: AASHTO T308-10: Standard Method of Test for Determining the Asphalt Binder Content of Hot Mix Asphalt (HMA) by the Ignition Method (Method A) (Asphalt Binder Content)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: (909) 829-3029
Data has not been verified.
