Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214322 DEA: 021H74U4 EFIS: 0218000043
QA Service Level: 1
DIST-CO-RTE-PM: 02-TEH-36-87.8/89.1
Work Description: CURVE REALIGNMENT AND EXTENDING THE TRUCK CLIMBING LANE.
Location Description: TEHAMA COUNTY NEAR MINERAL FROM 0.1 MILE TO 1.5 MILES EAST OF ROUTE 89
Contractor Name: STEVE MANNING CONSTRUCTION, INC
Contractor Address: 5211 Churn Creek Road, Redding, CA 96002
Resident Engineer: Tofael Anwar Structure Rep.: Unknown
DIME Sample ID: 2020-06-29-38
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Department Acceptance
Type of Material: Asphalt Binder
Sample Taken Date: 06/29/2020
Date that the sample was received by the laboratory/organization performing the testing: 07/13/2020
The quantity of what the sample constitutes: 1 can, NO test #7(no tl101)
A brief description of the sample: Asphalt Binder
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Marathon
Performance Grade: PG 64-28 M
Modified: Yes
Lot number: 1
Sublot number: 1
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier:
Multigrade:
Multigrade Type:
Asphalt Binder Mix Number:
