Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214848 DEA: 081H3414 EFIS: 0818000172
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-210,215,259-Various
Work Description: PLACE RHMA-G, COLD PLANE AC AND REPLACE AC SURFACING.
Location Description: SAN BERNARDINO COUNTY ON ROUTE 210, 215 AND 259 AT VARIOUS LOCATIONS
Contractor Name: All American Asphalt
Contractor Address: 400 E. 6th Street, PO Box 2229, Corona, CA 92878-2229
Resident Engineer: Rambod Sufipur Structure Rep.: Unknown
DIME Sample ID: 2020-10-20-18
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Hesperia Field Testing Laboratory
Sample Organization Contact: (951) 840-8242
Type of Sample: Acceptance
Type of Material: Concrete Core
Sample Taken Date: 10/20/2020
Date that the sample was received by the laboratory/organization performing the testing: 10/13/2020
The quantity of what the sample constitutes: 3
A brief description of the sample: Core
From where was the sample collected: Manufacturer
Laboratory sample identification: 407
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: All American Asphalt Corona
