Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000176 DEA: 034H76U4 EFIS: 0323000040
QA Service Level: 1
DIST-CO-RTE-PM: 03-BUT-32-5.0/10.2
Work Description: REHABILITATE PAVEMENT, INSTALL SIGNAL, LIGHTING, DRAINAGE, & ADA RAMPS
Location Description: BUTTE COUNTY IN CHICO FROM MUIR AVENUE TO INTERCHANGE OF STATE ROUTES 99 AND 32
Contractor Name: BALDWIN CONTRACTING COMPANY, INC. DBA KNIFE RIVER CONSTRUCTION
Contractor Address: 1764 SKYWAY, CHICO CA 95928
Resident Engineer: Husam Makhoul Structure Rep.: Unknown
DIME Sample ID: 2025-10-05-15
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: 10/05/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/17/2025
The quantity of what the sample constitutes: 1 jug
A brief description of the sample: SS1H 80/20
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Northwest Oil
DIME Test ID: 2025-10-05-15-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 10/20/2025
Date Tested: 10/20/2025
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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56.2 %
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Beaker 2 Residue
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56.2 %
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Percentage of residue
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56 %
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