Sample Record for 2024-04-06-3
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994327 DEA: 081G4704 EFIS: 0816000001
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-74-3.1/53.5
Work Description: STRUCTURAL CONC BR, CONC SLAB, HMA (TYPE A), ALT CRASH CUSHION SYSTEM.
Location Description: RIVERSIDE COUNTY NEAR LAKE ELSINORE AT MORRILL CANYON BRIDGE AND NEAR HEMET AT STRAWBERRY CREEK BRIDGE.
Contractor Name: BEADOR CONSTRUCTION COMPANY, INC.
Contractor Address: 26320 LESTER CIRCLE;, CORONA CA 92883
Resident Engineer: Mike A Bergevin Structure Rep.: Arnel Vega
Sample Information
DIME Sample ID: 2024-04-06-3
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: Production Start-Up
Type of Material: Aggregate
Sample Taken Date: 04/06/2024
Date that the sample was received by the laboratory/organization performing the testing: 04/08/2024
The quantity of what the sample constitutes: 2 Bags Combined, 1 Bag RAP
A brief description of the sample: 3/4" HMA-A-SP R15
From where was the sample collected: Supplier
Laboratory sample identification: 0163A-24
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: All American Asphalt - Corona
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-33-0005
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: Belt Cut at All American Asphalt - Corona
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: 105927
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
