Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214250 DEA: 021H3204 EFIS: 0215000126
QA Service Level: 1
DIST-CO-RTE-PM: 02-TEH-99-12.0/12.6
Work Description: CONSTRUCT CURB RAMPS AND SIDEWALKS.
Location Description: TEHAMA COUNTY AT LOS MOLINOS FROM JOSEPHINE STREET TO LOS MOLINOS CREEK BRIDGE
Contractor Name: TULLIS INC
Contractor Address: P O BOX 493416, REDDING CA 96049
Resident Engineer: Tofael Anwar Structure Rep.: Unknown
DIME Sample ID: 2020-07-26-4
TL Number from the TL Form: 853444
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: 07/26/2020
Date that the sample was received by the laboratory/organization performing the testing: 08/05/2020
The quantity of what the sample constitutes: 1 gal jug
A brief description of the sample: Tack oil ss1h
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Albina-Asphalt
DIME Test ID: 2020-07-26-4-2
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 08/13/2020
Date Tested: 08/13/2020
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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How many beakers will be used to conduct the test?
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4
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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 %
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Beaker 3 Residue
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59.2 %
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Beaker 4 Residue
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59.2 %
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Percentage of residue
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59.2 %
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