Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995520 DEA: 041Y7004 EFIS: 0423000016
QA Service Level: 1
DIST-CO-RTE-PM: 04-CC,SOL-80-13.8/14.1,0.0/0.4
Work Description: AL ZAMPA BRIDGE DECK REHABILITATION REPLACE TOP COURSE
Location Description: CONTRA COSTA AND SOLANO COUNTIES AT CROCKETT AND IN VALLEJO FROM UNION PACIFIC RAILROAD OVERHEAD TO 0.8 MILE SOUTH OF ROUTE 80/29 SEPARATION
Contractor Name: O.C. JONES & SONS, INC.
Contractor Address: 1520 fourth Street, Berkley, CA, 94710
Resident Engineer: Ferdinand Ciceron Structure Rep.: John Parecadan
DIME Sample ID: 2026-08-23-6
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: 08/23/2026
Date that the sample was received by the laboratory/organization performing the testing: 08/23/2026
The quantity of what the sample constitutes: 2 quart cans,
A brief description of the sample: Tack Coat Emulsion
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Northwest Oil
DIME Test ID: 2026-08-23-6-1
Test Method: AASHTO T59-25: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 08/25/2026
Date Tested: 08/25/2026
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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61.4 %
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Beaker 2 Residue
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61.8 %
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Percentage of residue
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62 %
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