Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994387 DEA: 023J7704 EFIS: 0222000082
QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-96-97.2/103.0
Work Description: RHMA OVERLAY, REPLACE AC SURFACING, GUARDRAIL AND TRAFFIC STRIPE.
Location Description: SISKIYOU COUNTY ABOUT 21 MILES EAST OF HORSE CREEK FROM 4.2 MILES EAST OF EMPIRE CREEK BRIDGE TO 0.4 MILE WEST OF ROUTE 263
Contractor Name: TULLIS INC.
Contractor Address: Unknown
Resident Engineer: Nicholas Riddle Structure Rep.: Unknown
DIME Sample ID: 2023-06-28-84
TL Number from the TL Form: 867324
Sample Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Sample Organization Contact: (530) 225-3194
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 06/28/2023
Date that the sample was received by the laboratory/organization performing the testing: 06/28/2023
The quantity of what the sample constitutes: JMF Verification
A brief description of the sample: Lime Treated 1/2-inch Virgin Aggregate
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Tullis Inc. - Northstate Asphalt (Redding CA)
Source Identification (SMARA, name of Pit or Job Site): Tullis - Northstate Asphalt
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Cold Feed
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
DIME Test ID: 2023-06-28-84-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Organization Address: 1657 Riverside Drive,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: 530-225-3194
Data has not been verified.
