Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000063 DEA: 061F8804 EFIS: 0623000106
QA Service Level: 1
DIST-CO-RTE-PM: 06-KIN-41-R39.9/R48.3
Work Description: COLD PLANE, HMA PAVING, AND INDIVIDUAL CONCRETE SLAB REPLACEMENT.
Location Description: KINGS COUNTY AT AND NEAR LEMOORE FROM ROUTE 41/198 SEPARATION TO FRESNO COUNTY LINE
Contractor Name: AGEE CONSTRUCTION CORPORATION
Contractor Address: 1039 Hoblitt Avenue, Clovis, CA
Resident Engineer: Oscar Sherrill Structure Rep.: Unknown
DIME Sample ID: 2024-07-10-84
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Acceptance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 07/10/2024
Date that the sample was received by the laboratory/organization performing the testing: 07/19/2024
The quantity of what the sample constitutes: 1 jar
A brief description of the sample: SS-1H Emulsified Asphalt
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Standard Emulsion
