Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 213827 DEA: 051K3904 EFIS: 0518000169
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-246-R16.7/R20.7
Work Description: RESURFACE EXISTING ROADWAY WITH RHMA (GAP GRADED).
Location Description: SANTA BARBARA COUNTY ABOUT 6 MILES WEST OF BUELLTON FROM HAPGOOD ROAD (EAST) TO 0.5 MILE EAST OF SANTA ROSA CREEK BRIDGE
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 5335 Debbie lane, Santa Barbara , CA 93111
Resident Engineer: David Ballentine Structure Rep.: Unknown
DIME Sample ID: 2019-04-22-5
TL Number from the TL Form:
Sample Submitted By Organization: Granite Construction Company - Buellton
Sample Organization Contact: (805) 331-1054
Type of Sample: Quality Control
Type of Material: Hot Mix Asphalt
Sample Taken Date: 04/22/2019
Date that the sample was received by the laboratory/organization performing the testing: 04/22/2019
The quantity of what the sample constitutes: 150 tons
A brief description of the sample: T283
From where was the sample collected: Manufacturer
Laboratory sample identification: 1935503802
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite - Gardner
