Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994785 DEA: 023H32U4 EFIS: 0221000164
QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-I5-2.5/R15.9
Work Description: Roadway rehabilitation and bridge improvements along I5 in Mount Shasta
Location Description: SIS I5 2.5/R15.9
Contractor Name: Gordon Stout - Walsh/Myers
Contractor Address: 1390 Willow Pass Rd Suite 950, Concord, CA 94520
Resident Engineer: Austin Henry Structure Rep.: Mike Sears
DIME Sample ID: 2023-07-14-34
TL Number from the TL Form: 852757
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Quality Assurance
Type of Material: Asphalt Binder
Sample Taken Date: 07/14/2023
Date that the sample was received by the laboratory/organization performing the testing: 07/25/2023
The quantity of what the sample constitutes: 1 Can
A brief description of the sample: PG 58-34 M (Valero - Benicia)
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Tullis Inc. - Northstate Asphalt (Redding CA)
Performance Grade: PG 58-34 M
Modified: Yes
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: Valero Marketing & Supply - Benicia CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:
DIME Test ID: 2023-07-14-34-1
Test Method: AASHTO T315-22: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
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
Data has not been verified.
DIME Test ID: 2023-07-14-34-2
Test Method: AASHTO T315-22: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
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
Data has not been verified.
DIME Test ID: 2023-07-14-34-3
Test Method: AASHTO T315-22: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
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
Data has not been verified.
DIME Test ID: 2023-07-14-34-4
Test Method: AASHTO T313-22: Standard Method of Test for Determining the Flexural Creep Stiffness of Asphalt Binder Using the Bending Beam Rheometer (BBR)
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
Data has not been verified.
