Sample Record for 2024-07-15-39
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 995291 DEA: 081N2504 EFIS: 0822000125
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-15,60,91,215-Var
Work Description: POLYESTER CONC OVERLAY, CLEAN EXP JT, DECK SEAL & HMA (BRIDGE).
Location Description: RIVERSIDE COUNTY AT VARIOUS LOCATIONS
Contractor Name: PETERSON-CHASE GENERAL ENGINEERING CONSTRUCTION, INC.
Contractor Address: 16315 Construction Circle West, Irvine, CA 92606
Resident Engineer: Xavier Avila Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2024-07-15-39
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: Verification
Type of Material: Aggregate
Sample Taken Date: 07/15/2024
Date that the sample was received by the laboratory/organization performing the testing: 07/19/2024
The quantity of what the sample constitutes: 4 Bags of Comb. Agg, 2 Bags Rap
A brief description of the sample: JMF 3/4" HMA-A-SP R15 No LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0336A-24
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: All American Asphalt Corona
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-33-0005
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Belt Cut at All American Asphalt Corona Plant
Where the material sample would have been placed if not sampled: Asphalt Paving
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: 105793
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
