Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001564 DEA: 030J4104 EFIS: 0319000281
QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-80-33.0/44.9
Work Description: COLD PLANE AC PVMT, HMA, CLASS 2 AB, RDWY EXC, MGS, & RCP.
Location Description: PLACER COUNTY IN AND NEAR COLFAX FROM 0.1 MILE WEST OF ROUTE 174/80 SEPARATION TO 0.1 MILE EAST OF ALTA ROAD UNDERCROSSING
Contractor Name: A. TEICHERT & SON, INC. DBA TEICHERT CONSTRUCTION
Contractor Address: 4401 Duluth Ave, Rocklin, CA 95765
Resident Engineer: Brigette Haddock Structure Rep.: Unknown
DIME Sample ID: 2026-06-22-34
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: 06/22/2026
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: ss-1h
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Northwest Oil - Stockton, CA
DIME Test ID: 2026-06-22-34-1
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: 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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60.2 %
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Beaker 2 Residue
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60 %
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Percentage of residue
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60 %
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