Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993121 DEA: 032H62U4 EFIS: 0319000021
QA Service Level: 1
DIST-CO-RTE-PM: 03-NEV-20-25.6/39.8
Work Description: ROADWAY EXCAVATION, HMA (TYPE A) WITH CLASS 2 AB, RCB CULVERT AND RCP.
Location Description: NEVADA COUNTY NEAR OMEGA AT VARIOUS LOCATIONS FROM 0.2 MILE WEST OF CONSERVATION ROAD (WASHINGTON RIDGE ROAD) TO 1.2 MILES WEST OF ZEIBRIGHT ROAD
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 4001 Bradshaw Road, Sacramento, CA 95827
Resident Engineer: Jeff Johnson Structure Rep.: Unknown
DIME Sample ID: 2022-08-10-63
TL Number from the TL Form: 803910
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: 08/10/2022
Date that the sample was received by the laboratory/organization performing the testing: 09/20/2022
The quantity of what the sample constitutes: 1 Can
A brief description of the sample: Binder
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Valero
Performance Grade: PG 58-22
Modified: No
Lot number: 1
Sublot number: 8
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: Valero Marketing & Supply - Benicia CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
