Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993535 DEA: 081M1104 EFIS: 0821000078
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-215-10.0/17.2
Work Description: HMA, COLD PLANE AC PAVEMENT, AND TRAFFIC STRIPE TAPE.
Location Description: SAN BERNARDINO COUNTY?FROM 0.1 MILE NORTH OF 27TH STREET TO 0.1 MILE SOUTH OF DEVORE ROAD
Contractor Name: CALMEX ENGINEERING INC.
Contractor Address: 2764 S VISTA AVE, BLOOMINGTON, CA 92316
Resident Engineer: VuThanh Nguyen Structure Rep.: Unknown
DIME Sample ID: 2022-07-15-46
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 07/15/2022
Date that the sample was received by the laboratory/organization performing the testing: 07/22/2022
The quantity of what the sample constitutes: 2 Boxes HMA 1516.17 tons out
A brief description of the sample: 3/4" HMA-A-SP R23 0.50% LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0487A-22
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan San Bernardino Portable
DIME Test ID: 2022-07-15-46-1
Test Method: AASHTO T308-10: Standard Method of Test for Determining the Asphalt Binder Content of Hot Mix Asphalt (HMA) by the Ignition Method (Method A) (Asphalt Binder Content)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
