Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000179 DEA: 081M8504 EFIS: 0822000054
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-111-0.0/18.5
Work Description: RHMA (GAP-GRADED), COLD PLANE AC PVMT, THERMOPLASTIC TRAFFIC STRIPE.
Location Description: RIVERSIDE COUNTY AT SALTON SEA FROM IMPERIAL COUNTY LINE TO 0.1 MILE NORTH OF 66TH AVENUE
Contractor Name: MARTIN MARIETTA SAN DIEGO AGGREGATES LLC DBA ATP GENERAL ENGINEERING CONTRACTORS
Contractor Address: 2225 Kansas Ave, Riverside, CA 92507
Resident Engineer: Khoi Vu Structure Rep.: Unknown
DIME Sample ID: 2024-08-28-14
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: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 08/28/2024
Date that the sample was received by the laboratory/organization performing the testing: 08/29/2024
The quantity of what the sample constitutes: 9 BOXES HMA, 1 QT PG64-16, 1 QT RUB BLND, 1 QT LAS
A brief description of the sample: 3/4" RHMA G SP .5% LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0443G-24
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Martin Marietta -Coachella
