Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994226 DEA: 042K7004 EFIS: 0417000010 COOP: 042895
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-880-R0.0/11.8
Work Description: Cold plane pavement and overlay with RHMA-G/RHMA-O (CAPITAL PREVENTIVE MAINTENANCE)
Location Description: ALAMEDA COUNTY IN FREMONT AND NEWARK FROM SANTA CLARA COUNTY LINE TO 0.4 MILE NORTH OF FREMONT BOULEVARD OVERCROSSING
Contractor Name: BAY CITIES PAVING & GRADING, INC.
Contractor Address: 1450 Civic Ct. BLDG B #400, Concord CA, 94520
Resident Engineer: Rodelio Baluyot Structure Rep.: Bettie C. "Betty" Geng
DIME Sample ID: 2024-06-06-98
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Hayward Field Laboratory
Sample Organization Contact: (510) 723-0168
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 06/06/2024
Date that the sample was received by the laboratory/organization performing the testing: 06/10/2024
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 1/2 RHMA-G
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan-Pleasanton
