Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215374 DEA: 060X2704 EFIS: 0618000048
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-5-37.2/48.8
Work Description: PAVEMENT REHABILITATION
Location Description: FROM 1.9 MILES NORTH OF THREE ROCKS ROAD UC TO 0.2 MILES SOUTH OF PANOCHE ROAD OC
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 2716 Granite Court, Fresno, CA 93706
Resident Engineer: Cary Cruz Structure Rep.: Unknown
DIME Sample ID: 2022-09-23-3
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Millbrook Field Laboratory
Sample Organization Contact: (559) 417-5341
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 09/23/2022
Date that the sample was received by the laboratory/organization performing the testing: 09/23/2022
The quantity of what the sample constitutes: 1200 tons
A brief description of the sample: 1/2 RHMA-G
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Coalinga HMA Plant
