Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214388 DEA: 051F6804 EFIS: 0514000046
QA Service Level: 1
DIST-CO-RTE-PM: 05-MON-1-39.8/74.6
Work Description: RHMA OVERLAY ON EXISTING ROADWAY AND REPLACE GUARDRAIL.
Location Description: MONTEREY COUNTY FROM TORRE CANYON BRIDGE NEAR BIG SUR TO SAN LUIS AVENUE IN CARMEL
Contractor Name: Graniterock Company
Contractor Address: 5225 Hellyer Ave, Ste 200, San Jose, CA 95138
Resident Engineer: Rodger Johnson Structure Rep.: David Galarza
DIME Sample ID: 2020-08-17-29
TL Number from the TL Form:
Sample Submitted By Organization: CT D05 - San Luis Obispo District Laboratory
Sample Organization Contact: (559) 230-3109
Type of Sample: Verification
Type of Material: Asphalt Rubber Binder
Sample Taken Date: 08/17/2020
Date that the sample was received by the laboratory/organization performing the testing: 08/27/2020
The quantity of what the sample constitutes: One JMF Renewal
A brief description of the sample: Quart can of ARB
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: FNF at Graniterock Aromas
Asphalt modifier supplier:
Performance Grade: PG 64-16
Lot number:
Sublot number:
Asphalt Rubber Binder Mix Number:
