Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212244 DEA: 044G8404 EFIS: 0413000051
QA Service Level: 1
DIST-CO-RTE-PM: 04-NAP-128-20.1/20.4
Work Description: REPLACE CAPELL CREEK BRIDGE
Location Description: NAPA COUNTY ABOUT 15 MILES EAST OF RUTHERFORD FROM 1.1 MILES EAST OF KNOXVILLE ROAD TO 0.3 MILE WEST OF CAPELL VALLEY CREST
Contractor Name: GORDON N BALL INC
Contractor Address: 333 CAMILLE AVENUE, ALAMO CA 94507
Resident Engineer: Darren Isada Structure Rep.: Nana Budu
DIME Sample ID: 2020-06-11-36
TL Number from the TL Form: C861394
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: 5625005861
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 06/11/2020
Date that the sample was received by the laboratory/organization performing the testing: 06/11/2020
The quantity of what the sample constitutes: 250 Tons
A brief description of the sample: HMA Type A
From where was the sample collected: Job Site
Laboratory sample identification: Con_20_087
Structure unique identifier: 28-Napa
Structure name: Capell Bridge
The fabricator/manufacturer/facility name: Syar Lake Herman Batch
DIME Test ID: 2020-06-11-36-1
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 - Unassigned/General Field Laboratory
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
Data has not been verified.
