Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215734 DEA: 024H0104 EFIS: 0218000068
QA Service Level: 1
DIST-CO-RTE-PM: 02-PLU-70-78.3/90.3
Work Description: REPLACE AC SURFACING, PLACE HMA AND THERMOPLASTIC TRAFFIC STRIPING.
Location Description: PLUMAS COUNTY NEAR PORTOLA FROM 0.4 MILE WEST OF BIG GRIZZLY CREEK BRIDGE TO 0.8 MILE WEST OF SUMMIT SCHOOL DRIVE
Contractor Name: HAT CREEK CONSTRUCTION & MATERIALS, INC.
Contractor Address: 243339 Hwy 89, N Burney, CA 96013
Resident Engineer: Mike Zdenek Structure Rep.: Unknown
DIME Sample ID: 2026-06-09-39
TL Number from the TL Form: 036638
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: No Test
Type of Material: Asphaltic Emulsion
Sample Taken Date: 06/09/2026
Date that the sample was received by the laboratory/organization performing the testing: 06/12/2026
The quantity of what the sample constitutes: 1 JUG OF CQSI
A brief description of the sample: CQSI
From where was the sample collected: Source
Laboratory sample identification: 5147
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: ALBINA
DIME Test ID: 2026-06-09-39-1
Test Method: AASHTO T59-25: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 06/22/2026
Date Tested: 06/22/2026
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: 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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62.6 %
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Beaker 2 Residue
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62.6 %
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Percentage of residue
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63 %
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