Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214314 DEA: 081F6904 EFIS: 0815000016
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-79-0.0/15.6
Work Description: COLD PLANE AC PAVEMENT AND PLACE RHMA-G.
Location Description: RIVERSIDE COUNTY NEAR TEMECULA FROM SAN DIEGO COUNTY LINE TO 0.4 MILE EAST OF BUTTERFIELD STAGE ROAD
Contractor Name: All American Asphalt
Contractor Address: P.O. Box 2229, Corona CA, 92878
Resident Engineer: Osama Abdalla Structure Rep.: Unknown
DIME Sample ID: 2020-05-06-12
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 05/06/2020
Date that the sample was received by the laboratory/organization performing the testing: 05/07/2020
The quantity of what the sample constitutes: 177.44
A brief description of the sample: 3/4" HMA-A-SP R15
From where was the sample collected: Source
Laboratory sample identification: 0216A-20
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA-Corona