Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000510 DEA: 060W79U4 EFIS: 0622000189
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER,TUL-99-56.4/57.6,0.0/13.5
Work Description: RDWY EXC, HMA, AGGREGATE BASE, CRCP, SIGN STR, AND STR EXC.
Location Description: KERN AND TULARE COUNTIES IN AND NEAR DELANO FROM 0.2 MILE SOUTH OF CECIL AVENUE OVERCROSSING TO 0.7 MILE NORTH OF AVENUE 100 OVERCROSSING
Contractor Name: Security Paving Company, Inc.
Contractor Address: 2915 Fairhaven Drive, Bakersfield, CA 93308
Resident Engineer: Jake Garcia Structure Rep.: Raman Guraya
DIME Sample ID: 2026-04-06-30
TL Number from the TL Form:
Sample Submitted By Organization: WSP USA - Phoenix
Sample Organization Contact: 480-519-9086
Type of Sample: Quality Assurance
Type of Material: Asphalt Binder
Sample Taken Date: 04/06/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/10/2026
The quantity of what the sample constitutes: 1 can
A brief description of the sample: 64-16
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: San Joaquin Refining Co Inc
Performance Grade: PG 64-16
Modified:
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier: Deer Creek Asphalt
Certified Asphalt Supplier: San Joaquin Refinery - Bakersfield CA
Multigrade: Yes
Multigrade Type:
Asphalt Binder Mix Number:
