Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000363 DEA: 010H5504 EFIS: 0117000235
QA Service Level: 1
DIST-CO-RTE-PM: 01-MEN-101-55.0/64.9
Work Description: HMA, RHMA, AND COLD PLANE ASPHALT CONCRETE PAVEMENT.
Location Description: MENDOCINO COUNTY NEAR LONGVALE FROM 2.6 MILES SOUTH OF ARNOLD BRIDGE OVERHEAD 10-179 TO 0.1 MILE NORTH OF LONG VALLEY CREEK BRIDGE 10-99
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 1324 S. State Street, Ukiah, CA 95482
Resident Engineer: Daniel Kraft Structure Rep.: Hayden Terrill
DIME Sample ID: 2025-09-21-13
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: 09/21/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/03/2025
The quantity of what the sample constitutes: 1 Jug
A brief description of the sample: tack coat 100%
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Northwest Oil - Stockton, CA
DIME Test ID: 2025-09-21-13-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 10/08/2025
Date Tested: 10/06/2025
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: not applicable
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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53.6 %
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Beaker 2 Residue
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53.6 %
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Percentage of residue
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54 %
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