Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994330 DEA: 09366404 EFIS: 0916000006
QA Service Level: 1
DIST-CO-RTE-PM: 09-MNO-395-58.2/60.4
Work Description: HOT MIX ASPHALT (TYPE A), IMPORTED BORROW, AND ROADWAY EXCAVATION.
Location Description: MONO COUNTY ABOUT 6 MILES NORTH OF LEE VINING FROM ROUTE 167 TO 0.4 MILE NORTH OF CONWAY RANCH ROAD
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 500 South Main Street, Bishop, CA 93514
Resident Engineer: David Carruba Structure Rep.: Unknown
DIME Sample ID: 2024-07-10-29
TL Number from the TL Form:
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Verification
Type of Material: Hot Mix Asphalt
Sample Taken Date: 07/10/2024
Date that the sample was received by the laboratory/organization performing the testing: 07/10/2024
The quantity of what the sample constitutes: JMF Verification
A brief description of the sample: 1/2" HMA Type A PG58-34M R15
From where was the sample collected: Source
Laboratory sample identification: JMF-01
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Lee Vining