Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001609 DEA: 040AA244 EFIS: 0419000455
QA Service Level: 1
DIST-CO-RTE-PM: 04-CC, -680-R0.0/R7.7
Work Description: INDIVIDUAL SLAB REPLACEMENT, COLD PLAN AC PVMT, GRIND EXIST CONC PVMT.
Location Description: CONTRA COSTA COUNTY IN SAN RAMON AND DANVILLE FROM THE ALAMEDA COUNTY LINE TO 0.2 MILE NORTH OF DIABLO ROAD UNDERCROSSING
Contractor Name: Bay Cities Paving and Grading
Contractor Address: 1450 Civic Ct., Bldg B #400, Concord, CA 94520
Resident Engineer: Eddie Dike Structure Rep.: Unknown
DIME Sample ID: 2026-10-02-41
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: No Test
Type of Material: Asphalt Rubber Binder
Sample Taken Date: 10/02/2026
Date that the sample was received by the laboratory/organization performing the testing: 10/09/2026
The quantity of what the sample constitutes: 2 cans
A brief description of the sample: 2 cans of Rubberized Binder
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan- Pleasanton
Asphalt modifier supplier: Pacific Northwest Oil
Performance Grade: PG 64-16
Lot number:
Sublot number:
Asphalt Rubber Binder Mix Number:
