Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000114 DEA: 060W8204 EFIS: 0617000304
QA Service Level: 1
DIST-CO-RTE-PM: 06-KIN-41-28.4/R40.1
Work Description: COLD PLANE WITH HOT MIX ASPHALT (TYPE A) AND RHMA-G.
Location Description: KINGS COUNTY AT AND NEAR STRATFORD FROM NEVADA AVENUE TO ROUTE 41/198 SEPARATION
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 2716 S Granite Ct, Fresno, CA 93706
Resident Engineer: Oscar Sherrill Structure Rep.: Martin Garcia
DIME Sample ID: 2024-08-08-87
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Acceptance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 08/08/2024
Date that the sample was received by the laboratory/organization performing the testing: 08/21/2024
The quantity of what the sample constitutes: 1 jar
A brief description of the sample: No TEST SS-1H 70/30 Emulsified Asphalt
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Construction
