Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994603 DEA: 09392404 EFIS: 0922000037
QA Service Level: 1
DIST-CO-RTE-PM: 09-KER-14,58-Var
Work Description: HOT MIX ASPHALT (TYPE A), REMOVE ASPHALT CONCRETE PAVEMENT, STRIPING.
Location Description: KERN COUNTY AT VARIOUS LOCATIONS
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2023-09-19-40
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: Department Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 09/19/2023
Date that the sample was received by the laboratory/organization performing the testing: 10/02/2023
The quantity of what the sample constitutes: 4 boxes of hma
A brief description of the sample: 3/4" HMA-A R25
From where was the sample collected: Manufacturer
Laboratory sample identification: 0501A-23
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite, Arvin
