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: 2020-09-29-37
TL Number from the TL Form: 979374
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Acceptance
Type of Material: Asphalt Rubber Binder
Sample Taken Date: 09/29/2020
Date that the sample was received by the laboratory/organization performing the testing: 10/07/2020
The quantity of what the sample constitutes: 1 can, NO TEST #2, #(972758), #3(972759)
A brief description of the sample: Asphalt Rubber Binder PG 64-16
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: San Joaquin Refinery
Asphalt modifier supplier:
Performance Grade: PG 64-16
Lot number: 1
Sublot number: 15
Asphalt Rubber Binder Mix Number:
