Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215552 DEA: 051N1904 EFIS: 0520000149
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-192-7.0/13.7
Work Description: COLD PLANE AND OVERLAY EXISTING ROADWAY WITH RHMA (GAP GRADED).
Location Description: SANTA BARBARA COUNTY AT VARIOUS LOCATIONS FROM COLD SPRING ROAD TO 0.9 MILE WEST OF NIDEVER ROAD
Contractor Name: TORO ENTERPRISES INC
Contractor Address: P O BOX 6285, OXNARD CA 93030
Resident Engineer: Kevin Murdock Structure Rep.: Unknown
DIME Sample ID: 2021-09-28-36
TL Number from the TL Form: 920257
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: 09/28/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/08/2021
The quantity of what the sample constitutes: 1 can
A brief description of the sample: NO TEST, 9/30
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite
Asphalt modifier supplier:
Performance Grade: PG 64-16
Lot number:
Sublot number:
Asphalt Rubber Binder Mix Number:
