Sample Record for 2023-09-09-5

Project ID: 994854 DEA: 061E5804 EFIS: 0622000071 QA Service Level: 1

DIST-CO-RTE-PM: 06-KER-43,46-9.0/15.7, 20.0/27.5

Work Description: FOR CONSTRUCTION ON STATE HIGHWAY IN KERN COUNTY NEAR WASCO ON ROUTE 43 FROM 0.2 MILE SOUTH OF ROUTE 58 TO 0.5 MILE NORTH OF RIVERSIDE AVENUE AND ROUTE 46 FROM 0.5 MILE WEST OF ROUTE 33 TO HOLLOWAY ROAD

Location Description: In District 06 On Route 43, 46

Contractor Name: AMERICAN PAVEMENT SYSTEMS , Inc.

Contractor Address: 1012 11th Street, Modesto, CA 95354

Resident Engineer: Jake Garcia Structure Rep.: Unknown

DIME Sample ID: 2023-09-09-5

TL Number from the TL Form:

Sample Submitted By Organization: CT D06 - Bakersfield Field Laboratory

Sample Organization Contact: 661-549-8281

Type of Sample: Department Acceptance

Type of Material: Hot Mix Asphalt

Sample Taken Date: 09/09/2023

Date that the sample was received by the laboratory/organization performing the testing: 07/28/2023

The quantity of what the sample constitutes: no sample , no one inform lab about this work

A brief description of the sample: 3/4 HMA-A

From where was the sample collected: Job Site

Laboratory sample identification:

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: jobsite

HMA Type: Type A HMA

HMA Grading: 3/4 inch

Lot number: 1

Sublot number: 6

Binder content (%):

Virgin binder PG:

Design binder PG:

Binder Supplier:

RAP content (%):

WMA Additives:

Antistrip type: