Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993521 DEA: 032G3504 EFIS: 0321000116
QA Service Level: 1
DIST-CO-RTE-PM: 03-COL-20-30.5/31.8
Work Description: HMA (TYPE A) AND CHIP SEAL.
Location Description: COLUSA COUNTY IN COLUSA FROM SIOC STREET TO FIRST STREET
Contractor Name: LAMON CONSTRUCTION
Contractor Address: 871 Von Geldern Way, Yuba City, cA 95991
Resident Engineer: Michael Mattson Structure Rep.: Unknown
DIME Sample ID: 2022-10-13-13
TL Number from the TL Form: 778701
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: 10/13/2022
Date that the sample was received by the laboratory/organization performing the testing: 10/14/2022
The quantity of what the sample constitutes: 2 jars
A brief description of the sample: MSE
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: 2022-10-13-13-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 10/17/2022
Date Tested: 10/17/2022
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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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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62.4 %
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Beaker 2 Residue
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61.6 %
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Percentage of residue
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62 %
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