Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215023 DEA: 060U4704 EFIS: 0615000301
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER,KIN-5-81.7/87.0,0.0/0.3
Work Description: CONSTRUCT CRCP, JPCP AND INSTALL TRAFFIC MONITORING STATIONS.
Location Description: KERN AND KINGS COUNTIES NEAR KETTELMAN CITY FROM 0.6 MILE SOUTH OF TWISSELMAN ROAD OVERCROSSING TO 0.3 MILE NORTH OF KERN/KINGS COUNTY LINE
Contractor Name: PAPICH CONSTRUCTION COMPANY, INC.
Contractor Address: P O BOX 2217, PISMO BEACH CA 93448
Resident Engineer: Din Dadawalla Structure Rep.: Unknown
DIME Sample ID: 2022-01-31-20
TL Number from the TL Form: 039931
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: 01/31/2022
Date that the sample was received by the laboratory/organization performing the testing: 02/02/2022
The quantity of what the sample constitutes: 1 of 1
A brief description of the sample: Project Sample
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: San Joaquin Refining Co Inc
Performance Grade: PG 70-10
Modified: No
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: San Joaquin Refinery - Bakersfield CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
