Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995036 DEA: 061E7704 EFIS: 0622000080
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-204-2.1/4.6
Work Description: TRANSPORTATION ART, TRAFFIC STRIPE, IRRIGATION AND PLANTING WORK.
Location Description: KERN COUNTY IN BAKERSFIELD FROM BRUNDAGE LANE TO M STREET
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 30005 James Road, Bakersfield, CA 93308
Resident Engineer: Samuel Garcia Structure Rep.: Unknown
DIME Sample ID: 2024-10-08-78
TL Number from the TL Form: 755196
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Verification
Type of Material: Asphaltic Emulsion
Sample Taken Date: 10/08/2024
Date that the sample was received by the laboratory/organization performing the testing: 10/15/2024
The quantity of what the sample constitutes: 2 cans
A brief description of the sample: PMCQS-1h 2.5% Latex
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Western Emulsions Irwindale
