Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001439 DEA: 061A7604 EFIS: 0621000015 COOP: NONE
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-46-51.4/R57.9
Work Description: COLD PLANE AC PAVEMENT, RHMA OVERLAY, CONC. BARRIER AND RUMBLE STRIPS.
Location Description: KERN COUNTY IN AND NEAR WASCO FROM 0.20 MILE EAST OF ROUTE 43 TO 0.30 MILE EAST OF ROUTE 46/99 SEPARATION
Contractor Name: Granite Construction
Contractor Address: 3005 James Road, Bakersfield, CA 93308
Resident Engineer: Alejandro Ruezga Structure Rep.: Ivan Cruz
DIME Sample ID: 2026-06-10-73
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Hayward Field Laboratory
Sample Organization Contact: (510) 723-0168
Type of Sample: No Test
Type of Material: Asphalt Binder
Sample Taken Date: 06/10/2026
Date that the sample was received by the laboratory/organization performing the testing: 06/10/2026
The quantity of what the sample constitutes: 1 Quart Can
A brief description of the sample: 1 CAN OF BINDER
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Solari
Performance Grade: PG 64-16
Modified:
Lot number: 1
Sublot number: 12
Tank number:
Time of sample:
HMA Supplier: Granite Solari
Certified Asphalt Supplier: San Joaquin Refinery - Bakersfield CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
