Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995240 DEA: 060X3804 EFIS: 0618000060
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-166-0.0/10.2
Work Description: COLD PLANE, PLACE HMA AND CONCRETE PAVEMENT, MODIFY DRAINAGE SYSTEM.
Location Description: KERN COUNTY IN AND NEAR MARICOPA FROM SOUTH JUNCTION ROUTE 33 TO 2.3 MILES WEST OF SAN EMIGDIO CREEK BRIDGE
Contractor Name: Griffith Company
Contractor Address: 1128 Carrier Parkway, Bakersfield ,CA 93308
Resident Engineer: Joy Denny Structure Rep.: Travis Landis
DIME Sample ID: 2024-09-10-43
TL Number from the TL Form: 056240
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Acceptance
Type of Material: Asphalt Binder
Sample Taken Date: 09/10/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/11/2024
The quantity of what the sample constitutes: 1 of 1
A brief description of the sample: PG 70-10 NO TEST
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Griffith Edmonston
Performance Grade: PG 70-10
Modified:
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: San Joaquin Refinery - Bakersfield CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
