Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002614 DEA: 081K6304 EFIS: 0819000083
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-18-T6.0/9.1
Work Description: CONSTRUCTION ON STATE HIGHWAY IN SAN BERNARDINO COUNTY IN SAN BERNARDINO FROM 29TH STREET TO 0.2 MILE SOUTH OF OLD WATERMAN CANYON ROAD.
Location Description: SAN BERNARDINO COUNTY IN THE CITY OF SAN BERNARDINO ON WATERMAN AVE
Contractor Name: Maneri Traffic Control
Contractor Address: 4949 SECOND STREET, FALLBROOK, CA 92028
Resident Engineer: Shaun Loza Structure Rep.: Unknown
DIME Sample ID: 2026-10-08-52
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: 10/08/2026
Date that the sample was received by the laboratory/organization performing the testing: 10/14/2026
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: Matich-Lytle Creek
Performance Grade: PG 58-22
Modified:
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier: n/a
Certified Asphalt Supplier: Valero Wilmington Refinery - Wilmington CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
HMA Type: n/a
HMA Supplier Mix ID Number: n/a
DIME Test ID: 2026-10-08-52-1
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: (213) 792-4797
Data has not been verified.
DIME Test ID: 2026-10-08-52-2
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: (213) 792-4797
Data has not been verified.
