Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994864 DEA: 050N74U4 EFIS: 0522000025
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-9.9/10.6
Work Description: SB 101 4D North San Ysidro to Olive Mill
Location Description: In Santa Barbara County in and near Santa Barbara from 0.1 mile south of San Ysidro Road Overcrossing to 0.1 north of Olive Mill Road Overcrossing
Contractor Name: Craig Flowers (Granite Construction Company)
Contractor Address: PO Box 6744, Santa Barbara, CA 93160
Resident Engineer: Taylor Merlo Structure Rep.: Emiliano Berntsen
DIME Sample ID: 2024-07-05-1
TL Number from the TL Form:
Sample Submitted By Organization: CT D05 - Carpinteria Field Laboratory
Sample Organization Contact: (805) 621-3616
Type of Sample: Acceptance
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 07/05/2024
Date that the sample was received by the laboratory/organization performing the testing: 07/05/2024
The quantity of what the sample constitutes: Multiple Lanes
A brief description of the sample: Skid Testing Request
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: Concrete Roadway
The fabricator/manufacturer/facility name: Granite Construction Company
Pavement Surface Type: PCC (Portland Cement Concrete)
Type of Traffic Control Provided: Behind K-Rail/Barrier
DIST-CO-RTE: 05-SB-101
Direction of Travel: South
Post Mile: 9.70
Lanes to be Tested: Shoulder,Lane #1
Station:
