Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001565 DEA: 030J4404 EFIS: 0319000285
QA Service Level: 1
DIST-CO-RTE-PM: 03-BUT-162-15.6/18.5
Work Description: COLD PLANE AC PVMT, HMA, MINOR CONCRETE, SIGNAL AND LIGHTING SYSTEM.
Location Description: BUTTE COUNTY IN OROVILLE FROM FEATHER RIVER BRIDGE TO FOOTHILL BOULEVARD
Contractor Name: Teichert & Son, Inc.
Contractor Address: 4401 Duluth Ave., Rocklin CA 95765
Resident Engineer: Dwayne Grandy Structure Rep.: Unknown
DIME Sample ID: 2026-08-10-51
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: 08/10/2026
Date that the sample was received by the laboratory/organization performing the testing: 08/17/2026
The quantity of what the sample constitutes: 1 OF 1 JUG
A brief description of the sample: SS-1H
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: PACIFIC NORTHWEST
DIME Test ID: 2026-08-10-51-1
Test Method: AASHTO T59-25: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 08/18/2026
Date Tested: 08/18/2026
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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59.2 %
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Beaker 2 Residue
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59.4 %
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Percentage of residue
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59 %
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