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Sample Record for 2021-10-14-74

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Project Information

Project ID: 208942 DEA: 100Y2104 EFIS: 1013000104 COOP: 10415 QA Service Level: 1
DIST-CO-RTE-PM: 10-TUO-108-R4.3/R5.1
Work Description: MODIFY AND WIDEN STRUCTURE
Location Description: AT PEACEFUL OAK ROAD INTERCHANGE ,PART OF EAST SONORA BYPASS
Contractor Name: SIERRA MOUNTAIN CONSTRUCTION INC.
Contractor Address: 13919 Mono Way, Sonora, CA 95370
Resident Engineer: Corey Casey Structure Rep.: Ehab Wahed

Sample Information

DIME Sample ID: 2021-10-14-74
TL Number from the TL Form: C1081014
Sample Submitted By Organization: CT D10 - District 10 Materials Laboratory
Sample Organization Contact: (209) 948-7567
Type of Sample: Verification
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/14/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/15/2021
The quantity of what the sample constitutes: 16 boxes of mix
A brief description of the sample: 3/4 HMA-A-SP, R12%
From where was the sample collected: Manufacturer
Laboratory sample identification: 21-J-042
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: George Reed - Table Mountain Plant

Material Information

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

Test Results