Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215005 DEA: 044J7504 EFIS: 0416000005
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-84-R0.73/3.06
Work Description: INSTALL OUTER SEPARATION BARRIERS Concrete barrier, shoulder widening, striping, cold plane and overlay.
Location Description: ALAMEDA COUNTY IN FREMONT FROM 0.7 MILE NORTH OF SAN MATEO COUNTY LINE TO 0.1 MILE SOUTH OF TOLL PLAZA
Contractor Name: BAY CITIES PAVING AND GRADING INC
Contractor Address: 55 SANTA CLARA AVE. SUITE 145, OAKLAND, CA 94520
Resident Engineer: Rodelio Baluyot Structure Rep.: Vincent Tang
DIME Sample ID: 2023-04-13-52
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Hayward Field Laboratory
Sample Organization Contact: (510) 723-0168
Type of Sample: Quality Assurance
Type of Material: Reclaimed Asphalt Pavement
Sample Taken Date: 04/13/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/14/2023
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 1/2" Recycled Asphalt Pavement
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Martin Marietta - Sunol
RAP Source: Stockpile @ Plant
Aggregate Size: 1/2
Aggregate Source: Martin Marietta - Sunol
RAP Stockpile: Static
Stockpile Size (tons):
Reclaimed Asphalt Pavement Mix Number:
