Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994729 DEA: 034H88U4 EFIS: 0323000024
QA Service Level: 1
DIST-CO-RTE-PM: 03-BUT-32-0.3/5.0
Work Description: INSTALL LIGHTING, WIDEN SHLD, UPGRADE END TREATMENTS, EXTEND CULVERTS.
Location Description: BUTTE COUNTY NEAR CHICO FROM 0.3 MILE EAST OF BUTTE COUNTY LINE TO MUIR AVENUE
Contractor Name: BALDWIN CONTRACTING COMPANY INC. DBA KNIFE RIVER CONSTRUCTION
Contractor Address: 1764 SKYWAY, CHICO, CA 95928
Resident Engineer: Dustin Watts Structure Rep.: Nicholas McLean
DIME Sample ID: 2023-09-11-58
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 Binder
Sample Taken Date: 09/11/2023
Date that the sample was received by the laboratory/organization performing the testing: 09/19/2023
The quantity of what the sample constitutes: 1 of 1 can
A brief description of the sample: pg 64-16
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Knife River, Orland
Performance Grade: PG 64-16
Modified:
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: Pacific Northwest Oil - Stockton CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
