Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215530 DEA: 051N1704 EFIS: 0520000136
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-135-1.0/R7.2
Work Description: Construct pavement using partial depth recycling and pave with RHMA
Location Description: CONSTRUCTION ON STATE HIGHWAY IN SANTA BARBARA COUNTY NEAR LOS ALAMOS FROM 0.3 MILE NORTH OF DEN STREET TO SAN ANTONIO CREEK BRIDGE
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 2023 Preisker Lane, Suite B, Santa Maria, CA 93454
Resident Engineer: Lilian Bennetzen Structure Rep.: Unknown
DIME Sample ID: 2021-08-24-34
TL Number from the TL Form: 023703 and 5 copy
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: 08/24/2021
Date that the sample was received by the laboratory/organization performing the testing: 08/31/2021
The quantity of what the sample constitutes: 9 cans - Loads 1 to 6
A brief description of the sample: Asphalt Binder PG 64-10
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Construction
Performance Grade: PG 64-10
Modified: No
Lot number: 3
Sublot number:
Tank number:
Time of sample:
HMA Supplier: Granite Construction
Certified Asphalt Supplier: Valero Marketing & Supply - Wilmington CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
