Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214685 DEA: 024E46U4 EFIS: 0216000122
QA Service Level: 1
DIST-CO-RTE-PM: 02-LAS-36-6.0/14.6
Work Description: REPLACE BRIDGE, ROADWAY EXCAVATION, HMA, CLASS 2 AB AND DRAINAGE WORK.
Location Description: LASSEN COUNTY NEAR WESTWOOD FROM 1.3 MILES WEST OF GOODRICH CREEK BRIDGE TO 1.0 MILE WEST OF WILLARD CREEK ROAD
Contractor Name: Hat Creek Construction
Contractor Address: 24339 Highway 89 N, Burney, CA 96013
Resident Engineer: Tim Crosby Structure Rep.: Jeff Rothgery
DIME Sample ID: 2022-06-24-47
TL Number from the TL Form: 896417
Sample Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Sample Organization Contact: (530) 225-3194
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 06/24/2022
Date that the sample was received by the laboratory/organization performing the testing: 07/07/2022
The quantity of what the sample constitutes: 5 Boxes for 10,000 Ton Milestone
A brief description of the sample: 3/4 inch Lime treated Type A HMA 23 RAP PG 58-34M Marathon Fernley
From where was the sample collected: Manufacturer
Laboratory sample identification: D79082
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Hat Creek Construction and Materials - Ward Lake Plant (Litchfield, CA)
DIME Test ID: 2022-06-24-47-1
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 D02 - Redding Northern Regional Laboratory
Organization Address: 1657 Riverside Drive,
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.
