Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000007 DEA: 061F8304 EFIS: 0623000101
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-180-43.5/53.6
Work Description: COLD PLANE AC PAVEMENT, RHMA-G (BWC) AND HMA (TYPE A).
Location Description: FRESNO COUNTY NEAR KERMAN FROM GOLDENROD AVENUE TO BRAWLEY AVENUE
Contractor Name: CAL VALLEY CONSTRUCTION, INC.
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2024-08-21-87
TL Number from the TL Form: NA
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: 08/21/2024
Date that the sample was received by the laboratory/organization performing the testing: 08/30/2024
The quantity of what the sample constitutes: 1 of 1
A brief description of the sample: SS-1H 70-30 NO TEST
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: TULLY
