Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000913 DEA: 061G7804 EFIS: 0624000164
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-5-54.2/62.5
Work Description: COLD PLANE AC PAVEMENT, PLACE HMA (TYPE A) AND RHMA (OGFC).
Location Description: KERN COUNTY FROM 2.0 MILES NORTH OF ROUTE 5/58 SEPARATION TO 4.5 MILES NORTH OF ROWLEE ROAD OVERCROSSING
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 3005 James Road, Bakersfield, CA 93308
Resident Engineer: Alejandro "Alex" Ruezga Structure Rep.: Unknown
DIME Sample ID: 2025-08-05-51
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: Quality Assurance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 08/05/2025
Date that the sample was received by the laboratory/organization performing the testing: 08/12/2025
The quantity of what the sample constitutes: 2 JUGS OF EMULSION
A brief description of the sample: tack coat 70/30
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Centennial Asphalt
