Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993334 DEA: 051M3704 EFIS: 0519000130
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-154-23.8/29.2
Work Description: COLD PLANE EXISTING PAVEMENT, PLACE HMA-A AND HFST OVERLAY.
Location Description: SANTA BARBARA COUNTY NEAR SANTA BARBARA AT VARIOUS LOCATIONS FROM 0.4 MILE EAST OF STAGECOACH ROAD TO 0.8 MILE WEST OF SAN ANTONIO CREEK ROAD
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 2023 Preisker Lane, Unit B, Santa Maria, CA 93454
Resident Engineer: David Ballentine Structure Rep.: Unknown
DIME Sample ID: 2022-06-02-7
TL Number from the TL Form: Sacramento Caltrans lab
Sample Submitted By Organization: Kwik Bond Polymers
Sample Organization Contact: (760) 518-6064
Type of Sample: Quality Control
Type of Material: Polyester
Sample Taken Date: 06/02/2022
Date that the sample was received by the laboratory/organization performing the testing: 06/02/2022
The quantity of what the sample constitutes: 2 tankers
A brief description of the sample: 1 gallon can
From where was the sample collected: Source
Laboratory sample identification: 943114
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Kwik Bond Polymers, Benicia
