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Sample Record for 2022-06-22-28

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 213411 DEA: 030H10U4 EFIS: 0317000246 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-5-9.7/24.9
Work Description:
Location Description: Construction on state highway in Sacramento County in and near Sacramento from 1.1 miles south of Elk Grove Boulevard to American River Viaduct
Contractor Name: NOR CAL PAVING TEICHERT/GRANITE
Contractor Address: 400 Sunrise Ave. Ste. #300, Roseville, CA 95661
Resident Engineer: Daniel Tecle Structure Rep.: Pha Tran

Sample Information

DIME Sample ID: 2022-06-22-28
TL Number from the TL Form:
Sample Submitted By Organization: Blackburn Consulting
Sample Organization Contact: (916) 375-8706
Type of Sample: Per Request
Type of Material: Asphalt Binder
Sample Taken Date: 06/22/2022
Date that the sample was received by the laboratory/organization performing the testing: 06/22/2022
The quantity of what the sample constitutes: 1 jug tack coat
A brief description of the sample: Tack Coat
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Northwest Oil

Material Information

Performance Grade: PG 64-16
Modified:
Lot number: 2
Sublot number: 13
Tank number:
Time of sample:
HMA Supplier: Granite Construction Company - Bradshaw
Asphalt Binder Supplier: Granite Construction - Bakersfield CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:

Test Results