Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000002 DEA: 010M6404 EFIS: 0123000051
QA Service Level: 1
DIST-CO-RTE-PM: 01-LAK-29-R45.1/52.5
Work Description: RHMA-G, COLD PLANE AC PAVEMENT, AND PAVEMENT DELINEATION.
Location Description: LAKE COUNTY NEAR LAKEPORT FROM PARK WAY OVERCROSSING TO ROUTE 20
Contractor Name: ARGONAUT CONSTRUCTORS , INC.
Contractor Address: 360 Sutton Place, Santa Rosa, CA 95402
Resident Engineer: Daniel Kraft Structure Rep.: Unknown
DIME Sample ID: 2024-08-12-61
TL Number from the TL Form: C881514
Sample Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Sample Organization Contact: (915) 296-1892
Type of Sample: Quality Assurance
Type of Material: Crumb Rubber Modifier
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: 1 Bag
A brief description of the sample: High Natural
From where was the sample collected: Source
Laboratory sample identification: 24-0146
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite 175 HMA Plant
DIME Test ID: 2024-08-12-61-1
Test Method: CTM 385-July 2022: Method of Test for Crumb Rubber Modifier (CRM)
Verified Date: 08/29/2024
Date Tested: 08/26/2024
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: ryan.kester@dot.ca.gov
Organization Phone: (916) 227-7215
General Comments for this Test: Percent Fabric is 0.13% as per Test Method. Dime needs update.
Test Result Compliance:
Additional Comments When Verified:
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Fabric in CRM
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0.14 %
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Wire in CRM
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no data0 %
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