Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 209906 DEA: 033F6504 EFIS: 0313000038
QA Service Level: 1
DIST-CO-RTE-PM: 03-NEV-89-1.2/8.7
Work Description: COLD IN-PLACE RECYCLING AND HOT MIX ASPHALT OVERLAY.
Location Description: NEVADA COUNTY IN AND NEAR TRUCKEE FROM 0.7 MILE NORTH OF THE 80/267 JUNCTION TO THE SIERRA COUNTY LINE
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: P.O. Box 50085, Watsonville, CA 95077-5085
Resident Engineer: Jeff Johnson Structure Rep.: Unknown
DIME Sample ID: 2024-05-22-112
TL Number from the TL Form:
Sample Submitted By Organization: Blackburn Consulting
Sample Organization Contact: (916) 375-8706
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 05/22/2024
Date that the sample was received by the laboratory/organization performing the testing: 05/24/2024
The quantity of what the sample constitutes: 2 Boxes
A brief description of the sample: 3/4 HMA 58-22 SP 25% RAP
From where was the sample collected: Source
Laboratory sample identification: 3678
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Perkins
