Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000608 DEA: 100Q2104 EFIS: 1017000171
QA Service Level: 1
DIST-CO-RTE-PM: 10-AMA-88-5.5/14.3
Work Description: REPAIR FAILED PAVEMENT AND RESURFACE EXISTING PAVEMENT WITH HMA.
Location Description: AMADOR COUNTY NEAR MARTELL FROM 0.7 MILE WEST OF IONE-BUENA VISTA ROAD TO 0.2 MILE EAST OF KENNEDY FLAT ROAD
Contractor Name: BAY CITIES PAVING & GRADING, INC.
Contractor Address: 1450 Civic St. Bldg B #400, Concord, CA 94520
Resident Engineer: Jonathan Ngai Structure Rep.: Unknown
DIME Sample ID: 2025-08-22-33
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: Quality Assurance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 08/22/2025
Date that the sample was received by the laboratory/organization performing the testing: 08/22/2025
The quantity of what the sample constitutes: 2 Cans
A brief description of the sample: SS1H Fog Seal
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Vernalis
DIME Test ID: 2025-08-22-33-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 09/03/2025
Date Tested: 09/03/2025
Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (530) 713-6823
General Comments for this Test: Evaporation
Test Result Compliance: complies
Additional Comments When Verified:
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How many beakers will be used to conduct the test?
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2
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Beaker 1 Residue
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59.4 %
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Beaker 2 Residue
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59.4 %
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Percentage of residue
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59 %
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