Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000435 DEA: 030J01U4 EFIS: 0323000244
QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-28-0.1/11.0
Work Description: HMA (TYPE A), COLD PLANE AC PVMT, RDWY EXC, & CL 2 AB.
Location Description: PLACER COUNTY FROM 0.1 MILE EAST OF ROUTE 89 AT TAHOE CITY TO THE NEVADA STATE LINE AT KINGS BEACH
Contractor Name: MERCER-FRASER COMPANY
Contractor Address: PO Box 1006, Eureka, CA 95502
Resident Engineer: Douglas Hobbs Structure Rep.: Unknown
DIME Sample ID: 2026-06-18-40
TL Number from the TL Form:
Sample Submitted By Organization: Blackburn Consulting
Sample Organization Contact: (916) 375-8706
Type of Sample: Quality Assurance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 06/18/2026
Date that the sample was received by the laboratory/organization performing the testing: 06/22/2026
The quantity of what the sample constitutes: 1 gallon jug
A brief description of the sample: Tack coat
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Western Emulsions
DIME Test ID: 2026-06-18-40-1
Test Method: AASHTO T59-25: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 06/24/2026
Date Tested: 06/23/2026
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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63 %
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Beaker 2 Residue
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62.8 %
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Percentage of residue
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63 %
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