Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 209695 DEA: 08347704 EFIS: 0800000616
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-SR-58-0/12.9
Work Description: (Alternative Delivery) The CMGC project will upgrade SR 58 from 2- to 4-lanes in San Bernardino County from the Kern County line to 7.5 miles east of US-395.
Location Description: SR-58 / 395 Kramer Junction project. In San Bernardino County from the Kern County line to 7.5 miles east of US-395.
Contractor Name: KIEWIT INFRASTRUCTURE WEST CO.
Contractor Address: 2215 E 1ST STREET, VANCOUVER, WA 98661
Resident Engineer: Shaine Shahidi Structure Rep.: Osama Abdalla
DIME Sample ID: 2019-03-15-13
TL Number from the TL Form:
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: 5625005861
Type of Sample: Department Acceptance
Type of Material: Asphalt Binder
Sample Taken Date: 03/15/2019
Date that the sample was received by the laboratory/organization performing the testing: 03/18/2019
The quantity of what the sample constitutes: 1 Quart
A brief description of the sample: Modified Asphalt Binder
From where was the sample collected: Manufacturer
Laboratory sample identification: 0177
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: SJR
Performance Grade: PG64-28M
Modified: Yes
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier:
Multigrade:
Multigrade Type:
Asphalt Binder Mix Number:
DIME Test ID: 2019-03-15-13-1
Test Method: AASHTO T240-17: Standard Method of Test for Effect of Heat and Air on a Moving Film of Asphalt Binder (Rolling Thin-Film Oven Test)
Submitted By Organization: CT - Unassigned/General Field Laboratory
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
Data has not been verified.
