Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994976 DEA: 060X3304 EFIS: 0618000055
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-5-R0.0/4.4
Work Description: REPLACE ROADWAY PAVEMENT WITH HMA AND CONCRETE.
Location Description: KERN COUNTY AT AND NEAR LEBEC FROM LOS ANGELES COUNTY LINE TO GRAPEVINE CREEK
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: Unknown
Resident Engineer: Joy Denny Structure Rep.: Travis Landas
DIME Sample ID: 2024-08-13-42
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: Hot Mix Asphalt
Sample Taken Date: 08/13/2024
Date that the sample was received by the laboratory/organization performing the testing: 08/14/2024
The quantity of what the sample constitutes: L1SL12 10 boxes HMA
A brief description of the sample: 19mm HMA A w 25percent rap
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Solari
