Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000392 DEA: 07349904 EFIS: 0718000167
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-710-6.0/14.1
Work Description: CONSTRUCT MVPS, MGS, ROCK BLANKETS,AND PAVE BEYOND THE GORE.
Location Description: LOS ANGELES COUNTY IN LONG BEACH AND COMPTOM FROM SHORELINE DRIVE TO 0.2 MILE NORTH OF ALONDRA BOULEVARD OVERCROSSING
Contractor Name: WESTCOAST PUBLIC WORKS, INC.
Contractor Address: Unknown
Resident Engineer: Jeffrey Townsend Structure Rep.: Unknown
DIME Sample ID: 2026-02-02-34
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 Binder
Sample Taken Date: 02/02/2026
Date that the sample was received by the laboratory/organization performing the testing: 02/06/2026
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: AAA-Irwindale
Performance Grade: PG 64-16
Modified:
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: San Joaquin Refinery - Bakersfield CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
