Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212777 DEA: 021H1104 EFIS: 0215000106
QA Service Level: 1
DIST-CO-RTE-PM: 02-LAS-299-25.58/25.58
Work Description: BUILDING WORK.
Location Description: LASSEN COUNTY ABOUT 11 MILES EAST OF BIEBER AT THE ADIN MAINTENANCE STATION
Contractor Name: Walsh Construction Company II, LLC (Walsh)
Contractor Address: 1390 Willow Pass Road Suite 950, Concord, CA 94520
Resident Engineer: Mike Zdenek Structure Rep.: Chris Brace
DIME Sample ID: 2021-06-17-37
TL Number from the TL Form: 766443
Sample Submitted By Organization: CT D02 - North Region Materials Lab
Sample Organization Contact: (530) 225-3194
Type of Sample: Acceptance
Type of Material: Reclaimed Asphalt Pavement
Sample Taken Date: 06/17/2021
Date that the sample was received by the laboratory/organization performing the testing: 06/21/2021
The quantity of what the sample constitutes: 1 bag at 91.19 Tons
A brief description of the sample: RAP sample for PSE
From where was the sample collected: Manufacturer
Laboratory sample identification: D78847
Structure unique identifier:
Structure name: Not Applicable
The fabricator/manufacturer/facility name: Eagle Peak, Alturas, Ca
RAP Source: Unknown
Aggregate Size: 1/2 Inch
Aggregate Source: Unknown
RAP Stockpile: Continuous
Stockpile Size (tons): Unknown
DIME Test ID: 2021-06-17-37-1
Test Method: AASHTO T308-10: Standard Method of Test for Determining the Asphalt Binder Content of Hot Mix Asphalt (HMA) by the Ignition Method (Asphalt Binder Content)
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Dr,MS-83
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
Data has not been verified.
DIME Test ID: 2021-06-17-37-2
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 D02 - North Region Materials Lab
Organization Address: 1657 Riverside Dr,MS-83
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
Data has not been verified.
DIME Test ID: 2021-06-17-37-3
Test Method: AASHTO T30-19: Standard Method of Test for Mechanical Analysis of Extracted Aggregate (Mechanical Analysis)
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Dr,MS-83
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
Data has not been verified.