Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993603 DEA: 051N7004 EFIS: 0521000081
QA Service Level: 1
DIST-CO-RTE-PM: 05-SLO-166-16.0/21.0
Work Description: PARTIAL DEPTH RECYCLING AND OVERLAY WITH RHMA (GAP GRADED).
Location Description: SAN LUIS OBISPO COUNTY ABOUT 8 MILES EAST OF SANTA MARIA FROM 0.5 MILE WEST OF HUASNA RIVER BRIDGE TO 1.9 MILES WEST OF CUYAMA RIVER BRIDGE.
Contractor Name: PAPICH CONSTRUCTION COMPANY INC.
Contractor Address: Unknown
Resident Engineer: Thomas Petersen Structure Rep.: Unknown
DIME Sample ID: 2022-06-16-36
TL Number from the TL Form:
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: 06/16/2022
Date that the sample was received by the laboratory/organization performing the testing: 06/24/2022
The quantity of what the sample constitutes: 1 Can
A brief description of the sample: 3/4" Rhma-g w/ LIME ARB
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sierra Pacific Materials
Asphalt modifier supplier:
Performance Grade: PG 64-16
Lot number:
Sublot number:
Asphalt Rubber Binder Mix Number:
