Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993507 DEA: 061C3904 EFIS: 0621000164
QA Service Level: 1
DIST-CO-RTE-PM: 06-TUL-198-26.7/33.2
Work Description: APPLY GAP GRADED RHMA.
Location Description: TULARE COUNTY IN AND NEAR LEMON COVE FROM 0.2 MILE EAST OF AVENUE 324 TO 0.3 MILE WEST OF HORSE CREEK ROAD
Contractor Name: Griffith Company
Contractor Address: 1128 Carrier Parkway, Bakersfield ,CA 93308
Resident Engineer: Haidar Haddadin Structure Rep.: Unknown
DIME Sample ID: 2022-05-25-57
TL Number from the TL Form: C772663
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Department Acceptance
Type of Material: Asphalt Binder
Sample Taken Date: 05/25/2022
Date that the sample was received by the laboratory/organization performing the testing: 06/01/2022
The quantity of what the sample constitutes: 1 of 1
A brief description of the sample: BINDER
From where was the sample collected: Other
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: ALBINA
Performance Grade: PG 64-16
Modified: No
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: Albina Asphalt - Chowchilla CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
