Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002597 DEA: 021K0404 EFIS: 0224000045
QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-273-7/11
Work Description: Happy Valley BWC
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Edward Worden Structure Rep.: Unknown
DIME Sample ID: 2026-09-08-46
TL Number from the TL Form: 858087
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Production Start-Up
Type of Material: Asphalt Rubber Binder
Sample Taken Date: 09/08/2026
Date that the sample was received by the laboratory/organization performing the testing: 09/21/2026
The quantity of what the sample constitutes: 2, 1 quart cans
A brief description of the sample: 2 cans of Rubberized Binder
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JF Shea- Clear Creek
Asphalt modifier supplier: FNF Construction
Performance Grade: PG 64-16
Lot number:
Sublot number:
Asphalt Rubber Binder Mix Number:
DIME Test ID: 2026-09-08-46-1
Test Method: ASTM D217-21: Standard Test Methods for Cone Penetration of Lubricating Grease (Cone Penetration)
Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (530) 713-6823
Data has not been verified.
DIME Test ID: 2026-09-08-46-2
Test Method: ASTM D36-14ε1: Standard Test Method for Softening Point of Bitumen (Ring-and-Ball Apparatus) (Softening Point)
Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (530) 713-6823
Data has not been verified.
DIME Test ID: 2026-09-08-46-3
Test Method: ASTM D5329-20: Standard Test Methods for Sealants and Fillers, Hot-Applied, for Joints and Cracks in Asphalt Pavements and Portland Cement Concrete Pavements (Asphalt Pavement)
Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (530) 713-6823
Data has not been verified.
