Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 213118 DEA: 081F9704 EFIS: 0815000077
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-10,66And210-Varies
Work Description: COLD PLAN, SLURRY SEAL, ASPHALT CONCRETE SURFACING AND ADA RAMPS
Location Description: SAN BERNARDINO COUNTY AT VARIOUS LOCATIONS
Contractor Name: ALL AMERICAN ASPHALT
Contractor Address: 400 E. 6th Street, Corona CA ,92879
Resident Engineer: GODWIN EMUH Structure Rep.: Unknown
DIME Sample ID: 2018-07-25-23
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: 5625005861
Type of Sample: Acceptance
Type of Material: Asphalt Binder
Sample Taken Date: 07/25/2018
Date that the sample was received by the laboratory/organization performing the testing: 07/26/2018
The quantity of what the sample constitutes: 1 Quart
A brief description of the sample: Modified Asphalt Binder
From where was the sample collected: Job Site
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: SJR
Performance Grade: PG 64-28 M
Modified:
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier:
Multigrade:
Multigrade Type:
Asphalt Binder Mix Number:
DIME Test ID: 2018-07-25-23-1
Test Method: AASHTO T228-09r13: Standard Method of Test for Specific Gravity of Semi-Solid Asphalt Materials (Specific Gravity)
Submitted By Organization: CT - Unassigned/General Field Laboratory
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
Data has not been verified.
