Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000176 DEA: 034H76U4 EFIS: 0323000040
QA Service Level: 1
DIST-CO-RTE-PM: 03-BUT-32-5.0/10.2
Work Description: REHABILITATE PAVEMENT, INSTALL SIGNAL, LIGHTING, DRAINAGE, & ADA RAMPS
Location Description: BUTTE COUNTY IN CHICO FROM MUIR AVENUE TO INTERCHANGE OF STATE ROUTES 99 AND 32
Contractor Name: BALDWIN CONTRACTING COMPANY, INC. DBA KNIFE RIVER CONSTRUCTION
Contractor Address: 1764 SKYWAY, CHICO CA 95928
Resident Engineer: Husam Makhoul Structure Rep.: Unknown
DIME Sample ID: 2025-07-27-9
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: Asphaltic Emulsion
Sample Taken Date: 07/27/2025
Date that the sample was received by the laboratory/organization performing the testing: 07/28/2025
The quantity of what the sample constitutes: 1 jug
A brief description of the sample: Tack oil ss-1h 100%
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Northwest Oil
