Sample Record for 2026-08-14-64

Project ID: 1002572 DEA: 061H9704 EFIS: 0625000105 QA Service Level: 1

DIST-CO-RTE-PM: 06-MAD-152-R0.0/15.5

Work Description: MADERA COUNTY SLAB REPLACEMENT WITH DIGOUTS ON SR 59, 152. Cold plane AC, remove concrete pavement and place with HMA and RHMA.

Location Description: CONSTRUCTION ON STATE HIGHWAY IN MADERA COUNTY NEAR CHOWCHILLA FROM ROUTE 59/152 SEPARATION TO 0.1 MILE WEST OF ROUTE 99/152 SEPARATION.

Contractor Name: Granite Construction Company (Jorge Velazquez)

Contractor Address: Unknown

Resident Engineer: Alaa Ghoneim Structure Rep.: None None

DIME Sample ID: 2026-08-14-64

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: Asphaltic Emulsion

Sample Taken Date: 08/14/2026

Date that the sample was received by the laboratory/organization performing the testing: 08/19/2026

The quantity of what the sample constitutes: 1 JUG OF SS-1H

A brief description of the sample: SS-1H 70/30

From where was the sample collected: Job Site

Laboratory sample identification:

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: TALLEY OIL

Emulsion Grade: SS-1h

Lot Number:

Sub Lot:

Dilution Percentage Rate: 70/30