Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993300 DEA: 044J3004 EFIS: 0415000320
QA Service Level: 1
DIST-CO-RTE-PM: 04-NAP-29-29.3/36.9
Work Description: COLD PLANE AC, PLACE HMA (TYPE A) AND RHMA-G.
Location Description: NAPA COUNTY IN AND NEAR SAINT HELENA AND CALISTOGA FROM YORK CREEK BRIDGE TO ROUTE 128
Contractor Name: ARGONAUT CONSTRUCTION
Contractor Address: P. O. BOX 639, SANTA ROSA, CA 95402
Resident Engineer: Paramdeep Brar Structure Rep.: Unknown
DIME Sample ID: 2022-06-16-84
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Concord Field Laboratory
Sample Organization Contact: (510) 714-7019
Type of Sample: Verification
Type of Material: Hot Mix Asphalt
Sample Taken Date: 06/16/2022
Date that the sample was received by the laboratory/organization performing the testing: 06/16/2022
The quantity of what the sample constitutes: 80 tons
A brief description of the sample: 3/8" HMA WITH 15% RAP
From where was the sample collected: Supplier
Laboratory sample identification: CON_22_428
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: BoDean Santa Rosa
