Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214798 DEA: 031G4704 EFIS: 0318000236
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-12-0.0/6.2
Work Description: PLACE HMA (TYPE A) AND REPLACE THERMOPLASTIC TRAFFIC STRIPE.
Location Description: SACRAMENTO COUNTY FROM THE SACRAMENTO RIVER BRIDGE TO THE MOKELUMNE RIVER BRIDGE
Contractor Name: VINTAGE PAVING COMPANY, INC
Contractor Address: 119 MAIN ST;, WINTERS CA 95694
Resident Engineer: Structure Rep.: Unknown
DIME Sample ID: 2020-07-08-10
TL Number from the TL Form: 702679
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Department Acceptance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 07/08/2020
Date that the sample was received by the laboratory/organization performing the testing: 07/09/2020
The quantity of what the sample constitutes: 1 bottle
A brief description of the sample: 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 - Stockton, CA
DIME Test ID: 2020-07-08-10-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Residue and Oil Distillate (Sec. 6))
Verified Date: 07/13/2020
Date Tested: 07/13/2020
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:
Additional Comments When Verified:
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What parameters are being calculated?
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Percentage of oil residue
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Is this a polymer-modified emulsion
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No
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Percentage of oil residue
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57.9 %
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