Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995051 DEA: 023H6804 EFIS: 0218000006
QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-5-R28.8/R44.1
Work Description: PLACE RHMA, PAINT TRAFFIC STRIPE, & INSTALL FIBER OPTIC CABLE SYSTEM.
Location Description: SHASTA COUNTY ABOUT 6 MILES NORTH OF SHASTA LAKE CITY FROM PIT RIVER BRIDGE TO 1.2 MILES SOUTH OF DOG CREEK BRIDGE
Contractor Name: J.F. SHEA CONSTRUCTION, INC.
Contractor Address: 17400 CLEAR CREEK ROAD, REDDING, CA 96001
Resident Engineer: Kyle Higgins Structure Rep.: Unknown
DIME Sample ID: 2024-08-12-40
TL Number from the TL Form: C851379
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Production Start-Up
Type of Material: Asphalt Binder
Sample Taken Date: 08/12/2024
Date that the sample was received by the laboratory/organization performing the testing: 08/16/2024
The quantity of what the sample constitutes: 2 cans
A brief description of the sample: PG 58-22 3/4"HMA W/23.6% RAP
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Valero
Performance Grade: PG 58-22
Modified: No
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: Valero Marketing & Supply - Benicia CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
