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Sample Record for 2021-01-20-13

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 213707 DEA: 081C38U4 EFIS: 0817000196 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-10-6.7/R25.1
Work Description: Remove concrete pavement and base, and place HMA and JPCP
Location Description: ROUTE 10/60 SEPARATION IN BEAUMONT TO ROUTE 10/111 SEPARATION NEAR CABAZON.
Contractor Name: Coffman Specialties
Contractor Address: 9685 Via Excelencia, San Diego, CA 92126
Resident Engineer: Elvira Lenart Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-01-20-13
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: (951) 840-8328
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 01/20/2021
Date that the sample was received by the laboratory/organization performing the testing: 01/22/2021
The quantity of what the sample constitutes: 2 box, 3 cores
A brief description of the sample: HMA-A 3/4" PG 64-28M
From where was the sample collected: Manufacturer
Laboratory sample identification: 1A131, 1B131, 1C131
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CCA-Coachella

Material Information

HMA Type: Type A HMA
HMA Grading: 3/4 inch
Lot number: Unknown
Sublot number: Unknown
HMA Mix Number:

Test Results