Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994328 DEA: 081H0604 EFIS: 0816000130
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-74-34.3/45.1
Work Description: FIBER OPTIC CABLE SYSTEMS, RHMA, HMA, AND MINOR CONCRETE.
Location Description: RIVERSIDE COUNTY IN AND NEAR HEMET FROM WINCHESTER ROAD TO FAIRVIEW AVENUE
Contractor Name: GRIFFITH COMPANY
Contractor Address: Unknown
Resident Engineer: Omar Sanchez Structure Rep.: Arnel Vega
DIME Sample ID: 2023-07-27-75
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Verification
Type of Material: Asphalt Rubber Binder
Sample Taken Date: 07/27/2023
Date that the sample was received by the laboratory/organization performing the testing: 07/31/2023
The quantity of what the sample constitutes: 1 Quart Can
A brief description of the sample: Asphalt Rubber Binder
From where was the sample collected: Supplier
Laboratory sample identification: 0396-23
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA-Perris
Asphalt modifier supplier:
Performance Grade: PG 64-16
Lot number:
Sublot number:
Asphalt Rubber Binder Mix Number:
DIME Test ID: 2023-07-27-75-2
Test Method: ASTM D217-16: Standard Test Methods for Cone Penetration of Lubricating Grease (Cone Penetration)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
DIME Test ID: 2023-07-27-75-3
Test Method: ASTM D5329-16: Standard Test Methods for Sealants and Fillers, Hot-Applied, for Joints and Cracks in Asphalt Pavements and Portland Cement Concrete Pavements (Asphalt Pavement)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
