Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214383 DEA: 010G4804 EFIS: 0117000009
QA Service Level: 1
DIST-CO-RTE-PM: 01-MEN-162-17.4/17.8
Work Description: PLACE HMA AND HIGH FRICTION SURFACE TREATMENT.
Location Description: MENDOCINO COUNTY NEAR DOS RIOS FROM 2.2 MILES EAST TO 2.5 MILES EAST OF LAYTONVILLE DOS RIOS ROAD
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 585 West Beach St, Watsonville, CA 95077
Resident Engineer: Mojtaba Mosallai Structure Rep.: Unknown
DIME Sample ID: 2020-04-13-17
TL Number from the TL Form: 028257
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Department Acceptance
Type of Material: Asphalt Binder
Sample Taken Date: 04/13/2020
Date that the sample was received by the laboratory/organization performing the testing: 05/28/2020
The quantity of what the sample constitutes: 1 Can
A brief description of the sample: Modified Asphalt Binder
From where was the sample collected: Distributor
Laboratory sample identification: AB206031
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Unkown
Performance Grade: PG 64-28M
Modified: Yes
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier:
Multigrade:
Multigrade Type:
Asphalt Binder Mix Number:
DIME Test ID: 2020-04-13-17-1
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: 06/17/2020
Date Tested: 06/17/2020
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:
Test Result Compliance: complies
Additional Comments When Verified:
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Is mass change based on one or two containers?
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One
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Any material loss from containers during heating process/testing?
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No
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Mass of empty container #1
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178.9 grams
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Mass of container #1 before test (m1i)
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214.107 grams
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Mass of container #1 after test (m1f)
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213.91 grams
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Average mass change
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-0.56 percent
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