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Sample Record for 2026-07-28-74

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

Project Information

Project ID: 1000697 DEA: 021J75U4 EFIS: 0224000092 QA Service Level: 1
DIST-CO-RTE-PM: 02-LAS-36-14.4/R16.8
Work Description: PLACE HMA AND CLASS 2 AB, EXCAVATE ROADWAY, & INSTALL LIGHTING SYSTEM.
Location Description: LASSEN COUNTY ABOUT 9 MILES WEST OF SUSANVILLE FROM 1.3 MILES WEST TO 1.2 MILES EAST OF WILLARD CREEK ROAD
Contractor Name: HAT CREEK CONSTRUCTION & MATERIALS, INC.
Contractor Address: HAT CREEK CONSTRUCTION & MATERIALS, INC. 24339 Hwy 89 North, burney, CA, 96013
Resident Engineer: Daniel Gibbs Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2026-07-28-74
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: 07/28/2026
Date that the sample was received by the laboratory/organization performing the testing: 08/07/2026
The quantity of what the sample constitutes: 2 JUGS OF CQS-1
A brief description of the sample: CQS-1 Emulsion
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Albina - Klamath Falls, OR

Material Information

Emulsion Grade: CQS-1
Lot Number: 1
Sub Lot:
Dilution Percentage Rate: N/A
Test results on following page(s): 1

Test Results

Test

DIME Test ID: 2026-07-28-74-1
Test Method: AASHTO T59-25: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 08/11/2026
Date Tested: 08/11/2026
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:
How many beakers will be used to conduct the test? 2
Beaker 1 Residue 63.4 %
Beaker 2 Residue 59 %
Percentage of residue 61 %