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Sample Record for 2021-09-22-53

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

Project Information

Project ID: 214919 DEA: 060U4504 EFIS: 0615000298 QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-168-18.6/T25.5
Work Description: COLD PLANE AC PAVEMENT AND HOT MIX ASPHALT RESURFACING.
Location Description: FRESNO COUNTY NEAR PRATHER FROM 0.1 MILE EAST OF SAMPLE ROAD TO OAK CREEK ROAD
Contractor Name: Cal Valley Construction
Contractor Address: 5125 N. Gates Ave., Ste. 102, Fresno, CA, 93722-6414
Resident Engineer: Mark Mengoni Structure Rep.: Raman Guraya

Sample Information

DIME Sample ID: 2021-09-22-53
TL Number from the TL Form: c056919
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Department Acceptance
Type of Material: Asphalt Binder
Sample Taken Date: 09/22/2021
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: CMI FRESNO

Material Information

Performance Grade: PG 64-16
Modified: No
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier: CMI Fresno
Certified Asphalt Supplier: Valero-NuStar PAT - Pittsburg CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:

Test Results