Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994109 DEA: 060W1704 EFIS: 0617000103
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-41-R27.4/R28.5
Work Description: REMOVE AC PAVEMENT, WIDEN TRAVEL WAY, AND CONSTRUCT RETAINING WALL.
Location Description: FRESNO COUNTY IN FRESNO FROM 0.1 MILE SOUTH OF ASHLAN AVENUE OVERCROSSING TO SHAW AVENUE OVERCROSSING
Contractor Name: RNR Construction, Inc
Contractor Address: 8589 Thys Court, Sacramento, CA,95828
Resident Engineer: Mark Mengoni Structure Rep.: Benjamin Holton
DIME Sample ID: 2023-04-19-73
TL Number from the TL Form: C709967
Sample Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Department Acceptance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 04/19/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/02/2023
The quantity of what the sample constitutes: 1 of 1 Jug
A brief description of the sample: Tack oil ss1h
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Talley Oil - Madera
DIME Test ID: 2023-04-19-73-2
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 05/05/2023
Date Tested: 05/03/2023
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: evap
Test Result Compliance: does not comply
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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53.2 %
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Beaker 2 Residue
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52.8 %
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Percentage of residue
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53 %
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