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Sample Record for 2026-07-23-58

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 44444 DEA: ASCP EFIS: ASCP QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for Asphalt Supplier Certification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2026-07-23-58
TL Number from the TL Form:
Sample Submitted By Organization: Ergon Asphalt & Emulsions
Sample Organization Contact: (702) 736-2059
Type of Sample: Quality Control
Type of Material: Asphalt Binder
Sample Taken Date: 07/23/2026
Date that the sample was received by the laboratory/organization performing the testing: 07/23/2026
The quantity of what the sample constitutes: 1 of 1
A brief description of the sample: Blender
From where was the sample collected: Manufacturer
Laboratory sample identification: Z32211760
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Las Vegas, NV

Material Information

Performance Grade: PG 58-34 M
Modified: Yes
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: Ergon Asphalt & Emulsions Incorporated - Las Vegas NV
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
HMA Type:
HMA Supplier Mix ID Number:
Test results on following page(s): 1

Test Results

Test

DIME Test ID: 2026-07-23-58-13
Test Method: AASHTO T240-23: Standard Method of Test for Effect of Heat and Air on a Moving Film of Asphalt Binder (Rolling Thin-Film Oven Test)
Verified Date: 07/31/2026
Date Tested: 07/23/2026
Submitted By Organization: Ergon Asphalt & Emulsions
Organization Address: 3901 West Ponderosa Way,
Organization City: Las Vegas
Organization State: NV
Organization Zipcode: 89118
Organization Email: mayelin.serrano@ergon.com
Organization Phone: (702) 736-2059
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Is mass change based on one or two containers? Two
Is mass change correction factor needed? Yes
Average mass change -0.681 percent
Mass correction factor 0.012