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Sample Record for 2020-09-21-40

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 212535 DEA: 031A9204 EFIS: 0300020608 QA Service Level: 1
DIST-CO-RTE-PM: 03-SUT-20-5-11.3
Work Description: SUTTER BYPASS WIDENING AND REHAB
Location Description: NEAR YUBA CITY FROM SUTTER BYPASS TO 0.1 MILE WEST OF LYTLE ROAD.
Contractor Name: KNIFE RIVER CONSTRUCTION
Contractor Address: 1764 SKYWAY DR., CHICO, CA 95928
Resident Engineer: Anthony Granados Structure Rep.: Glen Lawson

Sample Information

DIME Sample ID: 2020-09-21-40
TL Number from the TL Form: 766397
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Acceptance
Type of Material: Asphalt Binder
Sample Taken Date: 09/21/2020
Date that the sample was received by the laboratory/organization performing the testing: 09/30/2020
The quantity of what the sample constitutes: 1 Can
A brief description of the sample: 2 cans each, #22(766397), #23(765831), #24(765834) No test
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Valero

Material Information

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:

Test Results