Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214892 DEA: 06442554 EFIS: 0612000176 COOP: 061699
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-46-29.7/31.9
Work Description: CONVERT 2-LANE TO 4-LANE HMA PAVEMENT AND CONSTRUCT NEW BRIDGE.
Location Description: KERN COUNTY AT AND NEAR LOST HILLS FROM 0.2 MILE WEST OF CALIFORNIA AQUEDUCT BRIDGE TO 1.4 MILES EAST OF LOST HILLS ROAD
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 3005 James Road, Bakersfield, CA 93308
Resident Engineer: Trever Shiplee Structure Rep.: Gabriel Macias
DIME Sample ID: 2021-11-16-49
TL Number from the TL Form: 772535
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Verification
Type of Material: Asphalt Binder
Sample Taken Date: 11/16/2021
Date that the sample was received by the laboratory/organization performing the testing: 02/22/2022
The quantity of what the sample constitutes: 1 of 1
A brief description of the sample: binder
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: San Joaquin Refinery
Performance Grade: PG 58-16
Modified: No
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: San Joaquin Refinery - Bakersfield CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
