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Sample Record for 2022-08-15-1

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 214469 DEA: 030H08U4 EFIS: 0319000029 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-50-L0.2/R6.1
Work Description: Sac 50 Design Build PLEASE NOTE THAT DESIGN BUILDER MUST PERFORM QUALITY VALIDATION TESTING IN ACCORDANCE WITH THE MATERIAL CONTROL SCHEDULE (MCS) FOR ITEMS SUCH AS STRANDS, HS BOLTS, ELASTOMERIC BEARING PADS, JOINT SEALANTS, COUPLERS & WELDED HOOPS, ETC
Location Description: FROM 0.1 MILE EAST OF I-5 TO 0.8 MILE EAST OF WATT AVE
Contractor Name: FLATIRON WEST INC
Contractor Address: 2100 Goodyear Rd., Benicia, CA 94510
Resident Engineer: Jim Rogers Structure Rep.: Brandon Thurber

Sample Information

DIME Sample ID: 2022-08-15-1
TL Number from the TL Form:
Sample Submitted By Organization: Blackburn Consulting
Sample Organization Contact: (916) 375-8706
Type of Sample: Quality Control
Type of Material: Hot Mix Asphalt
Sample Taken Date: 08/15/2022
Date that the sample was received by the laboratory/organization performing the testing: 08/15/2022
The quantity of what the sample constitutes: 10 Boxes
A brief description of the sample: 3/4" HMA-SP
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert

Material Information

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

Test Results