Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 211814 DEA: 031E7604 EFIS: 0300000273
QA Service Level: 1
DIST-CO-RTE-PM: 03-YUB-20,70-0.5/0.9,14.3/14.4
Work Description: REMOVE MEDIAN LANES, ADD LEFT TURN LANES, CHANNELIZE, MODIFY SIGNALS
Location Description: YUBA COUNTY IN MARYSVILLE ON ROUTE 20 FROM THE FEATHER RIVER BRIDGE AND OVERHEAD TO F STREET AND ON ROUTE 70 AT 4TH STREET TO 5TH STREET
Contractor Name: A. TEICHERT & SON, INC. DBA TEICHERT CONSTRUCTION
Contractor Address: 4401 Duluth Ave, Rocklin, CA 95765
Resident Engineer: Garrett Griffith Structure Rep.: Unknown
DIME Sample ID: 2018-03-28-3
TL Number from the TL Form: 1234567
Sample Submitted By Organization: CT D03 - Olivehurst Northern Regional Laboratory
Sample Organization Contact: (530) 741-4238
Type of Sample: Verification
Type of Material: Hot Mix Asphalt
Sample Taken Date: 03/28/2018
Date that the sample was received by the laboratory/organization performing the testing: 03/29/2018
The quantity of what the sample constitutes: JMF Verification
A brief description of the sample: for JMF verification
From where was the sample collected: Source
Laboratory sample identification: JMF17-014
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Aggregates
DIME Test ID: 2018-03-28-3-1
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Submitted By Organization: CT D03 - Olivehurst Northern Regional Laboratory
Organization Address: 5330 Arboga Road,
Organization City: Olivehurst
Organization State: CA
Organization Zipcode: 95961
Organization Email: jeff.herbert@dot.ca.gov
Organization Phone: (530) 741-4238
Data has not been verified.
