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: 2021-09-13-31
TL Number from the TL Form: c210917B
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: 09/13/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/30/2021
The quantity of what the sample constitutes: 1 can
A brief description of the sample: PG64-16 ARB
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Buellton
Asphalt modifier supplier:
Performance Grade: PG 64-16
Lot number: 1
Sublot number: 4
Asphalt Rubber Binder Mix Number:
