Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000661 DEA: 081J2704 EFIS: 0818000014
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-247-0.0/23.0
Work Description: RUBBERIZED HMA, HMA (TYPE A), COLD PLANE AC PVMT & REPLACE AC SURF.
Location Description: SAN BERNARDINO COUNTY IN YUCCA VALLEY FROM ROUTE 62 TO 0.4 MILE WEST OF GIN ROAD
Contractor Name: SULLY-MILLER CONTRACTING COMPANY
Contractor Address: 135 S State College Blvd, Brea, CA 92821
Resident Engineer: Walid Saoud Structure Rep.: Unknown
DIME Sample ID: 2025-07-27-34
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Verification
Type of Material: Asphalt Rubber Binder
Sample Taken Date: 07/27/2025
Date that the sample was received by the laboratory/organization performing the testing: 07/29/2025
The quantity of what the sample constitutes: 1can
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: Blue Diamond-Victorville
Asphalt modifier supplier:
Performance Grade: PG 64-16
Lot number:
Sublot number:
Asphalt Rubber Binder Mix Number:
DIME Test ID: 2025-07-27-34-1
Test Method: ASTM D36-14ε1: Standard Test Method for Softening Point of Bitumen (Ring-and-Ball Apparatus) (Softening Point)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: (909) 829-3029
Data has not been verified.
DIME Test ID: 2025-07-27-34-2
Test Method: ASTM D217-21: Standard Test Methods for Cone Penetration of Lubricating Grease (Cone Penetration)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: (909) 829-3029
Data has not been verified.
DIME Test ID: 2025-07-27-34-3
Test Method: ASTM D5329-20: Standard Test Methods for Sealants and Fillers, Hot-Applied, for Joints and Cracks in Asphalt Pavements and Portland Cement Concrete Pavements (Asphalt Pavement)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: (909) 829-3029
Data has not been verified.
