Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002057 DEA: 120V2404 EFIS: 1224000109
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-405-3.9/23.3
Work Description: Apply methacrylate, polyester concrete overlay, and deck spall repair.
Location Description: ORANGE COUNTY AT VARIOUS LOCATIONS FROM UNIVERSITY DRIVE OVERCROSSING TO N405-W22 CONNECTOR SEPARATION
Contractor Name: Myers & Sons Construction
Contractor Address: 45 Morrison Ave, Sacramento, CA 95838
Resident Engineer: Pedro Esparza Structure Rep.: Unknown
DIME Sample ID: 2026-06-12-59
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Verification
Type of Material: Asphalt Binder
Sample Taken Date: 06/12/2026
Date that the sample was received by the laboratory/organization performing the testing: 07/14/2026
The quantity of what the sample constitutes: 1can
A brief description of the sample: Asphalt Binder Sample
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA-Perris
Performance Grade: PG 64-10
Modified:
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: San Joaquin Refinery - Bakersfield CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
DIME Test ID: 2026-06-12-59-1
Test Method: AASHTO T228-22: Standard Method of Test for Specific Gravity of Semi-Solid Asphalt Materials (Specific Gravity)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: (909) 829-3029
Data has not been verified.
DIME Test ID: 2026-06-12-59-2
Test Method: AASHTO T240-23: Standard Method of Test for Effect of Heat and Air on a Moving Film of Asphalt Binder (Rolling Thin-Film Oven Test)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: (909) 829-3029
Data has not been verified.
DIME Test ID: 2026-06-12-59-3
Test Method: AASHTO T315-24: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: (909) 829-3029
Data has not been verified.
DIME Test ID: 2026-06-12-59-4
Test Method: AASHTO T315-24: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: (909) 829-3029
Data has not been verified.
DIME Test ID: 2026-06-12-59-5
Test Method: AASHTO T316-22: Standard Method of Test for Viscosity Determination of Asphalt Binder Using Rotational Viscometer
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: (909) 829-3029
Data has not been verified.
DIME Test ID: 2026-06-12-59-6
Test Method: AASHTO T44-23: Standard Method of Test for Solubility of Bituminous Materials
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: (909) 829-3029
Data has not been verified.
