Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002318 DEA: 061H9404 EFIS: 0625000102
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-33-0.0/14.5
Work Description: COLD PLANE AC PAVEMENT, PLACE RHMA-O AND HMA (TYPE A), ROADSIDE SIGNS AND STRIPING
Location Description: 06-KER-33, PM 0.0/14.5, IN AND NEAR MARICOPA
Contractor Name: Westrock General Engineering (Joe Archuleta)
Contractor Address: 7005 Downing Avenue, Bakersfield, CA 93308
Resident Engineer: Vanessa Valdez Structure Rep.: None None
DIME Sample ID: 2026-06-23-36
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Quality Assurance
Type of Material: Asphalt Binder
Sample Taken Date: 06/23/2026
Date that the sample was received by the laboratory/organization performing the testing: 06/29/2026
The quantity of what the sample constitutes: 1 can of 64-16
A brief description of the sample: 64-16
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: San Joaquin Refining Co Inc
Performance Grade: PG 64-16
Modified: No
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier: SOLARI HMA
Certified Asphalt Supplier: San Joaquin Refinery - Bakersfield CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
HMA Type:
HMA Supplier Mix ID Number:
