Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 213806 DEA: 060X9004 EFIS: 0618000180
QA Service Level: 1
DIST-CO-RTE-PM: 06-TUL-99-27.6/31.2
Work Description: COLD PLANE AC PAVEMENT AND PLACE RHMA OPEN GRADED (BWC)
Location Description: TULARE COUNTY IN TULARE FROM PAIGE ROAD OVERCROSSING TO 0.6 MILE SOUTH OF CARTMILL ROAD OVERCROSSING
Contractor Name: MERCER-FRASER COMPANY
Contractor Address: 77 2nd St, Eureka, CA 95501
Resident Engineer: Jake Garcia Structure Rep.: Unknown
DIME Sample ID: 2019-07-26-13
TL Number from the TL Form: 929034
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Quality Assurance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 07/26/2019
Date that the sample was received by the laboratory/organization performing the testing: 07/31/2019
The quantity of what the sample constitutes: 1
A brief description of the sample: EMULSION
From where was the sample collected: Job Site
Laboratory sample identification: AB192156
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Western Emulsions Inc
