Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001575 DEA: 061H9604 EFIS: 0625000104
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-46,119-VAR
Work Description: COLD PLANE AC PAVEMENT AND PLACING RHMA TYPE G.
Location Description: KERN COUNTY AT VARIOUS LOCATIONS
Contractor Name: Griffith Company (Edward Torres)
Contractor Address: 1128 Carrier Parkway Avenue, Bakersfield, CA 93308
Resident Engineer: Alejandro Ruezga Structure Rep.: Unknown
DIME Sample ID: 2026-04-15-21
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Bakersfield Field Laboratory
Sample Organization Contact: 661-549-8281
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 04/15/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/16/2026
The quantity of what the sample constitutes: L3SL25- 12 box RHMA, 2bags of cold feed,
A brief description of the sample: 1/2" RHMA-G
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Griffith Edmonston
HMA Type: RHMA-G
HMA Grading: 1/2 inch
Lot number: 3
Sublot number: 25
HMA Mix Number:
Binder content (%): 7.5
Virgin binder PG: PG 64-16
Design binder PG: PG 64-16
Binder Supplier: San Juaquin Refinery
RAP content (%): 0
WMA Additives: No
Antistrip type: LIme 0.8%
