Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995060 DEA: 081J2604 EFIS: 0818000012
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-215-R13.5/R19.5
Work Description: RHMA, REPLACE AC SURFACING, ROCK BLANKET, AND COMPOST.
Location Description: RIVERSIDE COUNTY IN MURRIETA AND MENIFEE FROM 1.0 MILE NORTH OF CLINTON KEITH ROAD TO 1.0 MILE NORTH OF NEWPORT ROAD
Contractor Name: MARTIN MARIETTA SAN DIEGO AGGREGATES LLC DBA ATP GENERAL ENGINEERING CONTRACTORS
Contractor Address: 4211 Ponderosa Avenue, Suite C, San Diego, CA 92123
Resident Engineer: Osama Abdalla Structure Rep.: Unknown
DIME Sample ID: 2024-07-25-15
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: Hot Mix Asphalt
Sample Taken Date: 07/25/2024
Date that the sample was received by the laboratory/organization performing the testing: 07/26/2024
The quantity of what the sample constitutes: 36 BOXES OF HMA, 6 BAGS OF COLD FEED AGG, 2 BAGS OF RAP, 6 QTS OF PG64-16, 2 QTS OF ANTI STRIP
A brief description of the sample: 3/4" HMA-A-SP R25 .5% LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0351A-24
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Martin Mariatta Lake Elsinore
