Sample Record for 2026-04-07-30
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000365 DEA: 033H9014 EFIS: 0323000075
QA Service Level: 1
DIST-CO-RTE-PM: 03-SOL,YOL-50,80,113-Var
Work Description: HMA, RHMA, SIGN STRUCTURE, CAMERA SYSTEMS, & FO CABLE SYSTEMS.
Location Description: SOLANO AND YOLO COUNTIES AT VARIOUS LOCATIONS
Contractor Name: DESILVA GATES CONSTRUCTION, LLC
Contractor Address: 3855 North Freeway Boulevard, Suite 100, Sacramento, CA 95834
Resident Engineer: Brent Bullard Structure Rep.: Michael Charak
Sample Information
DIME Sample ID: 2026-04-07-30
TL Number from the TL Form:
Sample Submitted By Organization: Mozamo Engineering, Incorporated
Sample Organization Contact: (916) 237-7161
Type of Sample: Quality Assurance
Type of Material: Asphalt Binder
Sample Taken Date: 04/07/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/10/2026
The quantity of what the sample constitutes: Daily Production
A brief description of the sample: PG 58-22
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: De Silva Gates - Marysville
Material Information
Performance Grade: PG 58-22
Modified: Yes
Lot number: 3
Sublot number: 1
Tank number: 3
Time of sample: 0900
HMA Supplier: De Silva Gates
Certified Asphalt Supplier: Valero Benicia Refinery - Benicia CA
Multigrade: Yes
Multigrade Type: PG 58-22 / PG 58-16
Asphalt Binder Mix Number: MD 6736
Test Results
