Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000509 DEA: 010H6004 EFIS: 0117000240
QA Service Level: 1
DIST-CO-RTE-PM: 01-MEN-1-33.7/R51.0
Work Description: HMA, RHMA, COLD PLANE, GUARDRAIL, AND DELINEATION.
Location Description: MENDOCINO COUNTY NEAR ELK FROM 0.1 MILE NORTH OF GREENWOOD CREEK BRIDGE TO 0.2 MILE NORTH OF LITTLE LAKE ROAD AT MENDOCINO
Contractor Name: ARGONAUT CONSTRUCTORS, INC.
Contractor Address: 1236 CENTRAL AVENUE, SANTA ROSA CA 95401
Resident Engineer: Mojtaba Mosallai Structure Rep.: Robert Lorenz
DIME Sample ID: 2025-07-31-37
TL Number from the TL Form: 778812
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: 07/31/2025
Date that the sample was received by the laboratory/organization performing the testing: 08/12/2025
The quantity of what the sample constitutes: 1 Can
A brief description of the sample: Asphalt Rubber Binder
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: BoDean Company Santa Rosa
Asphalt modifier supplier:
Performance Grade: PG 64-16
Lot number: 2
Sublot number: 5
Asphalt Rubber Binder Mix Number:
