Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214885 DEA: 080K1234 EFIS: 0815000242
QA Service Level: 1
DIST-CO-RTE-PM: 08---
Work Description:
Location Description:
Contractor Name: SULLY-MILLER CONTRACTING COMPANY
Contractor Address: 135 S STATE COLLEGE BLVD #400, BREA CA 92821
Resident Engineer: Taghreed Al-Khateeb Structure Rep.: Unknown
DIME Sample ID: 2020-10-13-48
TL Number from the TL Form: Blue Diamond
Sample Submitted By Organization: CT D08 - Hesperia Field Testing Laboratory
Sample Organization Contact: (951) 840-8242
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/13/2020
Date that the sample was received by the laboratory/organization performing the testing: 09/25/2020
The quantity of what the sample constitutes: 2 box, 2 cores
A brief description of the sample: I-15 SB "A" Line East EP; Sta 2264+96
From where was the sample collected: Job Site
Laboratory sample identification: 14-A, 14-B
Structure unique identifier:
Structure name: I-15 N Sidewinder Rd
The fabricator/manufacturer/facility name: OHL, Sully Miller
DIME Test ID: 2020-10-13-48-1
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 D08 - Hesperia Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
Data has not been verified.
