Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000826 DEA: 07344504 EFIS: 0718000061
QA Service Level: 1
DIST-CO-RTE-PM: 07-VEN-150-
Work Description: COLD PLANE AND OVERLAY, MODIFY TRAFFIC SIGNALS AND REPLACE CURB RAMPS.
Location Description: VENTURA COUNTY IN SANTA PAULA FROM 0.2 MILE NORTH OF BRIDGE ROAD TO SANTA MARIA STREET
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 4820 Mcgrath St. STE 101, Ventura CA. 93003
Resident Engineer: Joseph Tehrani Structure Rep.: Unknown
DIME Sample ID: 2026-05-18-34
TL Number from the TL Form: 0236G-26
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Verification
Type of Material: Crumb Rubber Modifier
Sample Taken Date: 05/18/2026
Date that the sample was received by the laboratory/organization performing the testing: 05/19/2026
The quantity of what the sample constitutes: JMF; 3 Hi-Nat
A brief description of the sample: 3/4" RHMA-G 0.5% LAS
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite - Santa Paula
