Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 213720 DEA: 024H2004 EFIS: 0218000094
QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-89-26.3/29.2
Work Description: PAVEMENT OVERLAY
Location Description: SHASTA COUNTY ABOUT 10 MILES NORTH OF BURNEY FROM 0.3 MILE NORTH OF CLARK CREEK ROAD TO LAKE BRITTON BRIDGE
Contractor Name: Hat Creek Construction
Contractor Address: 24339 Highway 89 N, Burney, CA 96013
Resident Engineer: TOFAEL ANWAR Structure Rep.: Unknown
DIME Sample ID: 2019-04-09-15
TL Number from the TL Form:
Sample Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Sample Organization Contact: (530) 225-3194
Type of Sample: Quality Control
Type of Material: Reclaimed Asphalt Pavement
Sample Taken Date: 04/09/2019
Date that the sample was received by the laboratory/organization performing the testing: 04/09/2019
The quantity of what the sample constitutes: Mix Design
A brief description of the sample: -3/8 inch RAP
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Shaw Pit Facility
RAP Source: Shaw Pit Facility
Aggregate Size: Fine
Aggregate Source: Unknown
RAP Stockpile:
Stockpile Size (tons): Unknown
Reclaimed Asphalt Pavement Mix Number:
DIME Test ID: 2019-04-09-15-1
Test Method: AASHTO T308-10: Standard Method of Test for Determining the Asphalt Binder Content of Hot Mix Asphalt (HMA) by the Ignition Method (Method A) (Asphalt Binder Content)
Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Organization Address: 1657 Riverside Drive,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: 530-225-3194
Data has not been verified.
DIME Test ID: 2019-04-09-15-2
Test Method: AASHTO T30-15: Standard Method of Test for Mechanical Analysis of Extracted Aggregate (Mechanical Analysis)
Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Organization Address: 1657 Riverside Drive,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: 530-225-3194
Data has not been verified.
