Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
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
DIME Sample ID: 2020-01-30-47
TL Number from the TL Form: 013020043
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Verification
Type of Material: Asphalt Binder
Sample Taken Date: 01/30/2020
Date that the sample was received by the laboratory/organization performing the testing: 02/13/2020
The quantity of what the sample constitutes: 4 Cans
A brief description of the sample: Asphalt Binder Sample
From where was the sample collected: Manufacturer
Laboratory sample identification: AB205023
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: World Oil
Performance Grade: PG58-22
Modified: No
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier:
Multigrade:
Multigrade Type:
Asphalt Binder Mix Number:
DIME Test ID: 2020-01-30-47-1
Test Method: AASHTO T240-17: Standard Method of Test for Effect of Heat and Air on a Moving Film of Asphalt Binder (Rolling Thin-Film Oven Test)
Verified Date: 03/16/2020
Date Tested: 03/16/2020
Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Organization Address: 5900 Folsom Boulevard, Room 225,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (916) 227-7302
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
|
Is mass change based on one or two containers?
|
One
|
|
Any material loss from containers during heating process/testing?
|
No
|
|
Mass of empty container #1
|
167.792 grams
|
|
Mass of container #1 before test (m1i)
|
202.866 grams
|
|
Mass of container #1 after test (m1f)
|
202.878 grams
|
|
Average mass change
|
0.034 percent
|
