Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995125 DEA: 101E3004 EFIS: 1018000273
QA Service Level: 1
DIST-CO-RTE-PM: 10-SJ-5-32.5/49.8
Work Description: REMOVE EXISTING PAVEMENT AND REPLACE WITH CONCRETE PAVEMENT.
Location Description: SAN JOAQUIN COUNTY IN AND NEAR STOCKTON FROM 0.2 MILE SOUTH OF HAMMER LANE UNDERCROSSING TO SACRAMENTO COUNTY LINE
Contractor Name: BAY CITIES PAVING & GRADING, INC.
Contractor Address: 1450 Civic Court, Building B #400, Concord, CA 95351
Resident Engineer: Ariel Mendoza Structure Rep.: Unknown
DIME Sample ID: 2026-03-10-37
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: Verification
Type of Material: Asphalt Binder
Sample Taken Date: 03/10/2026
Date that the sample was received by the laboratory/organization performing the testing: 03/16/2026
The quantity of what the sample constitutes: 1 of 1
A brief description of the sample: Tank 18
From where was the sample collected: Manufacturer
Laboratory sample identification: 26-0310PNO-18
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Stockton, CA
Performance Grade: PG 64-16
Modified:
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: Pacific Northwest Oil - Stockton CA
Multigrade: Yes
Multigrade Type:
Asphalt Binder Mix Number:
