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Sample Record for 2023-07-10-5

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Project Information

Project ID: 215349 DEA: 081C0824 EFIS: 0816000087 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-10-R104.9/R134.2
Work Description: PLACE HMA (TYPE A), JPCP AND IMPORTED BORROW.
Location Description: RIVERSIDE COUNTY FROM ROUTE 10/177 SEPARATION TO 1.1 MILES WEST OF WILEY'S WELL RD OC
Contractor Name: FISHER SAND & GRAVEL CO.
Contractor Address: 1302 W DRIVERS WAY, TEMPE, AZ. 85284
Resident Engineer: Khoi Vu Structure Rep.: Shukri Abouazra

Sample Information

DIME Sample ID: 2023-07-10-5
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: 07/10/2023
Date that the sample was received by the laboratory/organization performing the testing: 07/10/2023
The quantity of what the sample constitutes: 3 boxes,185.18 tons out
A brief description of the sample: 3/4"HMA-A-SP-R24 1.0% LSM
From where was the sample collected: Manufacturer
Laboratory sample identification: 0357A-23
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Fisher Sand and Gravel-Tempe

Material Information

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

Test Results