Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214527 DEA: 020H69U4 EFIS: 0218000060
QA Service Level: 1
DIST-CO-RTE-PM: 02-TRI-299-10.9/11.2,42.9/43.3
Work Description: INSTALL ROCK FALL DRAPERY
Location Description: TRINITY COUNTY NEAR BURNT RANCH FROM 0.4 MILE EAST OF HENNESSEY ROAD TO 0.3 MILE WEST OF BURNT RANCH SCHOOL ROAD AND FROM 0.5 MILE WEST OF CANYON CREEK BRIDGE TO CANYON CREEK BRIDGE
Contractor Name: Access Limited Construction
Contractor Address: 1102 Pike Lane, Oceano, CA 93445
Resident Engineer: Sunil Repaka Structure Rep.: Unknown
DIME Sample ID: 2020-10-05-19
TL Number from the TL Form: 853471
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: 10/05/2020
Date that the sample was received by the laboratory/organization performing the testing: 10/23/2020
The quantity of what the sample constitutes: 1 Can
A brief description of the sample: AB PG 58-34M #3 No test
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Valero - Benicia, CA
Performance Grade: PG 58-34 M
Modified: Yes
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Time of sample:
HMA Supplier:
Certified Asphalt Supplier:
Multigrade:
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