Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215494 DEA: 081H4904 EFIS: 0817000059
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-18-31.9/38.5
Work Description: COLD PLANE AC PAVEMENT AND OVERLAY WITH HMA (TYPE A).
Location Description: SAN BERNARDINO COUNTY FROM 0.1 MILE EAST OF HILLTOP CONNECTOR TO 0.5 MILE EAST OF SIBERIA CREEK TRAIL
Contractor Name: Matich Corp
Contractor Address: P.O. Box 10, Highland, CA 92346-1010
Resident Engineer: Nhan Nguyen Structure Rep.: Unknown
DIME Sample ID: 2023-08-28-38
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Barstow Field Laboratory 1
Sample Organization Contact: (760) 252-9216
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 08/28/2023
Date that the sample was received by the laboratory/organization performing the testing: 08/29/2023
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: 3/4" HMA A
From where was the sample collected: Manufacturer
Laboratory sample identification: test2 at905ons out at1224Pm
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Diamond Victorville
DIME Test ID: 2023-08-28-38-1
Test Method: AASHTO T30-19: Standard Method of Test for Mechanical Analysis of Extracted Aggregate (Mechanical Analysis)
Submitted By Organization: CT D08 - Barstow Field Laboratory 1
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
Data has not been verified.
