Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994109 DEA: 060W1704 EFIS: 0617000103
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-41-R27.4/R28.5
Work Description: REMOVE AC PAVEMENT, WIDEN TRAVEL WAY, AND CONSTRUCT RETAINING WALL.
Location Description: FRESNO COUNTY IN FRESNO FROM 0.1 MILE SOUTH OF ASHLAN AVENUE OVERCROSSING TO SHAW AVENUE OVERCROSSING
Contractor Name: RNR Construction, Inc
Contractor Address: 8589 Thys Court, Sacramento, CA,95828
Resident Engineer: Mark Mengoni Structure Rep.: Benjamin Holton
DIME Sample ID: 2024-07-21-9
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Millbrook Field Laboratory
Sample Organization Contact: (559) 341-3953
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 07/21/2024
Date that the sample was received by the laboratory/organization performing the testing: 07/21/2024
The quantity of what the sample constitutes: 0-750 Tons
A brief description of the sample: 3/4 HMA-SP Type A
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Madera Plant
