Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994509 DEA: 101R4004 EFIS: 1023000140
QA Service Level: 1
DIST-CO-RTE-PM: 10-MER,MER/MER-5,59,152-22.6/32.5
Work Description:
Location Description:
Contractor Name: George Reed
Contractor Address: P.O. Box 4760, Modesto, CA 95352
Resident Engineer: Tofael Anwar Structure Rep.: Unknown
DIME Sample ID: 2002-04-13-1
TL Number from the TL Form: C644729
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: 04/13/2002
Date that the sample was received by the laboratory/organization performing the testing: 04/19/2023
The quantity of what the sample constitutes: 1 can of binder
A brief description of the sample: Asphalt binder
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: George Reed Munn & Perkins Plant
Performance Grade: PG 64-28 M
Modified: Yes
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: Albina Asphalt - Chowchilla CA
Multigrade: Yes
Multigrade Type:
Asphalt Binder Mix Number:
