Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001572 DEA: 060W9204 EFIS: 0618000063
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-5-4.1/10.7
Work Description: RDWY EXC, CRCP, JPCP, HMA, TEMP BARRIER SYSTEM, AND AGGREGATE SUBBASE.
Location Description: KERN COUNTY NEAR GRAPEVINE FROM 0.3 MILE SOUTH OF GRAPEVINE CREEK BRIDGE TO 0.5 MILE NORTH OF GRAPEVINE ROAD UNDERCROSSING
Contractor Name: C.A. RASMUSSEN INC
Contractor Address: 28548 Livingston Ave., Valencia, CA 91355
Resident Engineer: Kristopher Raber Structure Rep.: Albert Heredia
DIME Sample ID: 2026-05-06-60
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: 05/06/2026
Date that the sample was received by the laboratory/organization performing the testing: 05/13/2026
The quantity of what the sample constitutes: 1 plastic jug
A brief description of the sample: 1 Quart bottle
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sustainable Emulsions LLC
DIME Test ID: 2026-05-06-60-1
Test Method: AASHTO T59-25: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 05/18/2026
Date Tested: 05/18/2026
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:
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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58.6 %
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Beaker 2 Residue
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56 %
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Percentage of residue
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57 %
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