Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001389 DEA: 030J5204 EFIS: 0319000293
QA Service Level: 1
DIST-CO-RTE-PM: 03-NEV,PLA-20-Var
Work Description: CAPITAL PREVENTIVE MAINTENANCE (CAPM) - COLD PLANE AC PVMT, HMA (TYPE A), & DRAINAGE SYSTEMS.
Location Description: NEVADA AND PLACER COUNTIES AT VARIOUS LOCATIONS FROM 0.1 MILE EAST OF DOW ROAD TO 0.5 MILE EAST OF YUBA PASS SEPARATION AND OVERHEAD
Contractor Name: KNIFE RIVER COMPANY
Contractor Address: 1764 SKYWAY, CHICO, CA 95928
Resident Engineer: Lucas Price Structure Rep.: Unknown
DIME Sample ID: 2026-06-24-37
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: 06/24/2026
Date that the sample was received by the laboratory/organization performing the testing: 06/26/2026
The quantity of what the sample constitutes: 1 Jug
A brief description of the sample: Emulsion
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Northwest Oil
DIME Test ID: 2026-06-24-37-1
Test Method: AASHTO T59-25: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 06/30/2026
Date Tested: 06/29/2026
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: not applicable
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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53.2 %
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Beaker 2 Residue
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53 %
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Percentage of residue
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53 %
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