Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215552 DEA: 051N1904 EFIS: 0520000149
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-192-7.0/13.7
Work Description: COLD PLANE AND OVERLAY EXISTING ROADWAY WITH RHMA (GAP GRADED).
Location Description: SANTA BARBARA COUNTY AT VARIOUS LOCATIONS FROM COLD SPRING ROAD TO 0.9 MILE WEST OF NIDEVER ROAD
Contractor Name: TORO ENTERPRISES INC
Contractor Address: P O BOX 6285, OXNARD CA 93030
Resident Engineer: Kevin Murdock Structure Rep.: Unknown
DIME Sample ID: 2021-10-13-30
TL Number from the TL Form: -
Sample Submitted By Organization: CT D05 - Santa Barbara Field Laboratory
Sample Organization Contact:
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/13/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/13/2021
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: Gradation
From where was the sample collected: Source
Laboratory sample identification: 1348
Structure unique identifier:
Structure name: 36
The fabricator/manufacturer/facility name: Granite - Gardner
