Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 213297 DEA: 010H3704 EFIS: 0117000165
QA Service Level: 1
DIST-CO-RTE-PM: 01-LAK-20-33.6/37.1,45.2/46.5
Work Description: RUBBERIZED HOT MIX ASPHALT - GAP GRADED AND MIDWEST GUARDRAIL SYSTEM
Location Description: LAKE COUNTY NEAR CLEARLAKE OAKS FROM 0.6 MILE EAST OF NEW LONG VALLEY ROAD TO NORTH FORK CACHE CREEK BRIDGE AND FROM 1.4 MILES EAST OF ABBOT MINE ROAD TO COLUSA COUNTY LINE
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 1324 S. State Street, Ukiah, CA 95482
Resident Engineer: Dan Kraft Structure Rep.: Unknown
DIME Sample ID: 2018-08-16-9
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT D01 - District 1 Materials Laboratory
Sample Organization Contact: (707) 496-0974
Type of Sample: Verification
Type of Material: Hot Mix Asphalt
Sample Taken Date: 08/16/2018
Date that the sample was received by the laboratory/organization performing the testing: 08/18/2018
The quantity of what the sample constitutes: JMF Verification
A brief description of the sample: 1/2 in RHMA-G
From where was the sample collected: Manufacturer
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite HWY 175
