Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001090 DEA: 021K0504 EFIS: 0224000046
QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-44-L0.4/L1.8
Work Description: COLD PLANE AC PVMT AND RHMA (GAP GRADED).
Location Description: SHASTA COUNTY IN REDDING FROM CONTINENTAL UNDERCROSSING NO. 06-0135L TO ROUTE 5/44 SEPARATION
Contractor Name: J.F. SHEA CONSTRUCTION, INC.
Contractor Address: Unknown
Resident Engineer: Nathan Alexander Structure Rep.: Unknown
DIME Sample ID: 2025-07-20-12
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: No Test
Type of Material: Asphalt Rubber Binder
Sample Taken Date: 07/20/2025
Date that the sample was received by the laboratory/organization performing the testing: 07/24/2025
The quantity of what the sample constitutes: 2 Cans
A brief description of the sample: PG 64-16
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JF Shea Fawndale
Asphalt modifier supplier:
Performance Grade: PG 64-16
Lot number:
Sublot number:
Asphalt Rubber Binder Mix Number:
