Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214775 DEA: 081F13U4 EFIS: 0819000074
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-62,95-122.0/142.7,9.7/33.6
Work Description: COLD-IN PLACE RECYCLING AND PLACE RHMA-G.
Location Description: SAN BERNARDINO COUNTY ON ROUTE 62 FROM 3.8 MILES WEST OF ROUTE 95 TO ARIZONA STATE LINE AND ON ROUTE 95 FROM ROUTE 62 TO 2.0 MILES SOUTH OF TURTLE MOUNTAIN ROAD
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 38000 Monre St., Indio CA. 92203
Resident Engineer: Khoa Nguyen Nguyen Structure Rep.: Unknown
DIME Sample ID: 2020-10-20-22
TL Number from the TL Form: 20A 20B 20C
Sample Submitted By Organization: CT D08 - Barstow Field Laboratory 1
Sample Organization Contact: (760) 252-9216
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/20/2020
Date that the sample was received by the laboratory/organization performing the testing: 11/05/2020
The quantity of what the sample constitutes: 3
A brief description of the sample: 1/2 HMA core
From where was the sample collected: Job Site
Laboratory sample identification: 850 tons out, lot 2 SL19
Structure unique identifier:
Structure name: RTE 62 WB STA 649
The fabricator/manufacturer/facility name: Granite Construction