Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993150 DEA: 051G9704 EFIS: 0516000008
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-135-11.7/17.8
Work Description: COLD PLANE, OVERLAY ROADWAY WITH RHMA (GAP GRADED) AND ADA CURB RAMPS.
Location Description: SANTA BARBARA COUNTY IN AND NEAR SANTA MARIA FROM LAKEVIEW ROAD TO NORTH SANTA MARIA CONNECTOR
Contractor Name: CAL PORTLAND CONSTRUCTION
Contractor Address: 1625 E. Donovan, Santa Maria, Ca 93454
Resident Engineer: Thomas Petersen Structure Rep.: Unknown
DIME Sample ID: 2022-04-26-37
TL Number from the TL Form: 220426
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: 04/26/2022
Date that the sample was received by the laboratory/organization performing the testing: 05/11/2022
The quantity of what the sample constitutes: NO Test, 4/26, 4/27, 5/4, 5/5
A brief description of the sample: Asphalt Rubber Binder
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Cal Portland Garey Plant
Asphalt modifier supplier:
Performance Grade: PG 64-16
Lot number: 1
Sublot number: 1
Asphalt Rubber Binder Mix Number:
