Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000165 DEA: 09392504 EFIS: 0923000029
QA Service Level: 1
DIST-CO-RTE-PM: 09-INY-395-R17.2/25.8
Work Description: HOT MIX ASPHALT (TYPE A), SHOULDER BACKING, & STRIPING.
Location Description: INYO COUNTY ABOUT 9 MILES SOUTH OF OLANCHA FROM 0.8 MILE SOUTH OF SYKES ROAD TO 0.3 MILE NORTH OF HAIWEE CANYON ROAD
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 8999 Capacity Street, Arvin, CA 93203
Resident Engineer: Garret Rottner Structure Rep.: Unknown
DIME Sample ID: 2024-09-25-95
TL Number from the TL Form: 998375
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Acceptance
Type of Material: Asphalt Binder
Sample Taken Date: 09/25/2024
Date that the sample was received by the laboratory/organization performing the testing: 10/09/2024
The quantity of what the sample constitutes: 1 can
A brief description of the sample: PG 58-34 M
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Construction
Performance Grade: PG 58-34 M
Modified: Yes
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier: Granite
Certified Asphalt Supplier: San Joaquin Refinery - Bakersfield CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
