Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002511 DEA: 022K2104 EFIS: 0225000051
QA Service Level: 1
DIST-CO-RTE-PM: 02-TEH-36,172-unknown
Work Description:
Location Description: FOR CONSTRUCTION ON STATE HIGHWAY IN TEHAMA COUNTY NEAR MINERAL ON ROUTE 36 FROM 1.3 MILES EAST OF NORTH JUNCTION ROUTE 89 TO 0.1 MILE WEST OF MILL CREEK BRIDGE AND ON ROUTE 172 FROM 0.7 MILE WEST OF DOGWOOD WAY TO EAST JUNCTION OF ROUTE 36.
Contractor Name: Dig It Construction
Contractor Address: 803 Lorraine Dr, P.O. Box 494, Chester, CA 96020
Resident Engineer: Damion Farley Structure Rep.: Unknown
DIME Sample ID: 2026-08-26-52
TL Number from the TL Form: 037279
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: No Test
Type of Material: Asphaltic Emulsion
Sample Taken Date: 08/26/2026
Date that the sample was received by the laboratory/organization performing the testing: 09/25/2026
The quantity of what the sample constitutes: 1 jar
A brief description of the sample: CQS-1 Emulsion
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Albina - Klamath Falls, OR
