Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000850 DEA: 061G8204 EFIS: 0624000169
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-33-46.8/47.4,53.4/61.4
Work Description: PARTIAL DEPTH RECYCLING AND HMA.
Location Description: FRESNO COUNTY IN AND NEAR MENDOTA FROM 0.4 MILE NORTH OF KAMM AVENUE TO MOUNTAIN VIEW AVENUE AND FROM ADAMS AVENUE TO BELMONT AVENUE
Contractor Name: ARCHER CIVIL CONSTRUCTION, LLC.
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2025-09-29-50
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: 09/29/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/14/2025
The quantity of what the sample constitutes: 1 Jug
A brief description of the sample: SS1H
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: TALLEY OIL INC
DIME Test ID: 2025-09-29-50-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 10/15/2025
Date Tested: 10/15/2025
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: EVAP
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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30.2 %
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Beaker 2 Residue
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30.4 %
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Percentage of residue
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30 %
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