Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000008 DEA: 061F8404 EFIS: 0623000102
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-33-R60.2/73.7
Work Description: COLD PLANE WITH HOT MIX ASPHALT AND RUBBERIZED HOT MIX ASPHALT.
Location Description: KERN COUNTY FROM ROUTE 46 TO KINGS COUNTY LINE
Contractor Name: PAPICH CONSTRUCTION COMPANY, INC.
Contractor Address: 398 SUNRISE TERRACE;, ARROYO GRANDE CA 93420
Resident Engineer: Jake Garcia Structure Rep.: Unknown
DIME Sample ID: 2024-07-18-24
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Bakersfield Field Laboratory
Sample Organization Contact: 661-549-8281
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 07/18/2024
Date that the sample was received by the laboratory/organization performing the testing: 07/18/2024
The quantity of what the sample constitutes: L2S11 2 bags cold feeds and 1 bags of virgin aggregate
A brief description of the sample: 1/2 RHMA-G
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sierra Pacific - Avenal
Source Identification (SMARA, name of Pit or Job Site): 91-10-0006
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: coldfeed
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number: 2
Sublot number: 11
Aggregate Mix Number:
