Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 44444 DEA: ASCP EFIS: ASCP
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for Asphalt Supplier Certification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2025-01-27-32
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Verification
Type of Material: Asphalt Binder
Sample Taken Date: 01/27/2025
Date that the sample was received by the laboratory/organization performing the testing: 02/18/2025
The quantity of what the sample constitutes: 1 of 1
A brief description of the sample: Tank 502
From where was the sample collected: Manufacturer
Laboratory sample identification: 25-015
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Glendale, AZ
Performance Grade: PG 64-28 M
Modified: Yes
Lot number:
Sublot number:
Tank number:
Time of sample: 1/27/25 6:40
HMA Supplier:
Certified Asphalt Supplier: Holly Frontier Asphalt Company - Glendale AZ
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
DIME Test ID: 2025-01-27-32-1
Test Method: AASHTO T315-24: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (530) 713-6823
Data has not been verified.
