Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 99999 DEA: 0322222
QA Service Level:
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Michael Maksimovich Structure Rep.: Unknown
DIME Sample ID: 2017-06-07-12
TL Number from the TL Form: T101 C852340
Sample Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Sample Organization Contact: (562) 500-5861
Type of Sample: Acceptance
Type of Material: Job Mix Formula Partial
Sample Taken Date: 06/07/2017
Date that the sample was received by the laboratory/organization performing the testing: 06/07/2017
The quantity of what the sample constitutes: 16 boxs 17lb ea
A brief description of the sample: 19mm HMA A w 25percent rap
From where was the sample collected: Manufacturer
Laboratory sample identification: D76969
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JF Shea Fawndale
Source Identification (SMARA, name of Pit or Job Site): unknown
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Loader at plant
Where the material sample would have been placed if not sampled: Unknown
Superpave or Non-superpave Mix: Superpave
DIME Test ID: 2017-06-07-12-1
Test Method: AASHTO T96-02r10: Standard Method of Test for Resistance to Degradation of Small-Size Coarse Aggregate by Abrasion and Impact in the Los Angeles Machine (Los Angeles Rattler)
Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
Data has not been verified.
