Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215713 DEA: 060X3104 EFIS: 0618000052
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-145-20.3/26.1
Work Description: RESURFACE WITH HMA(TYPE A) AND RHMA-G.
Location Description: FRESNO COUNTY NEAR KERMAN FROM KAMM AVENUE TO MANNING AVENUE
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 2716 Granite Court, Fresno, CA 93706
Resident Engineer: Cary Cruz Structure Rep.: Unknown
DIME Sample ID: 2021-09-28-12
TL Number from the TL Form: c040599
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: 09/28/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/01/2021
The quantity of what the sample constitutes: 1 can
A brief description of the sample: 64-16
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Coalinga
Performance Grade: PG 64-16
Modified: No
Lot number: 1
Sublot number: 6
Tank number:
Time of sample:
HMA Supplier: Granite Coalinga
Certified Asphalt Supplier: San Joaquin Refinery - Bakersfield CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
