Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214659 DEA: 060U4904 EFIS: 0616000002
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-204-5.1/6.7
Work Description: COLD PLANE AC PVMT, OVERLAY WITH HMA & RHMA, MODIFY SIGNAL & LIGHTING.
Location Description: KERN COUNTY IN BAKERSFIELD FROM F STREET TO ROUTE 204/99 SEPARATION
Contractor Name: Coral Construction Co.
Contractor Address: P.O. Box 347, Wilsonville, OR 97070
Resident Engineer: Amarjit Dhaliwal Structure Rep.: Unknown
DIME Sample ID: 2020-07-08-27
TL Number from the TL Form: 771788
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: 07/08/2020
Date that the sample was received by the laboratory/organization performing the testing: 07/17/2020
The quantity of what the sample constitutes: 1 Can, #3 No test (771788)
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: San Joaquin Refinery
Performance Grade: PG 64-16
Modified: No
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier:
Multigrade:
Multigrade Type:
Asphalt Binder Mix Number: