Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993694 DEA: 010L0004 EFIS: 0121000040
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-299-R22.5/R30.7
Work Description: MICROSURFACING.
Location Description: HUMBOLDT COUNTY FROM REDWOOD CREEK BRIDGE TO 1.6 MILES EAST OF TITLOW HILL ROAD
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 1120 Terminal Way, Reno, NV 89502
Resident Engineer: Ethan Retherford Structure Rep.: Unknown
DIME Sample ID: 2023-04-10-77
TL Number from the TL Form:
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: 04/10/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/27/2023
The quantity of what the sample constitutes: 2 bottles of emulsion
A brief description of the sample: Emulsion
From where was the sample collected: Source
Laboratory sample identification: 01-0L0004
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Western Emulsion White City
DIME Test ID: 2023-04-10-77-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 05/01/2023
Date Tested: 05/01/2023
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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64.8 %
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Beaker 2 Residue
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62.8 %
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Percentage of residue
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64 %
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