Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994166 DEA: 051H8104 EFIS: 0516000164
QA Service Level: 1
DIST-CO-RTE-PM: 05-SBT-25-18.8/19.2
Work Description: ROADWAY EXCAVATION, HMA, CULVERTS AND SIGNAL SYSTEM.
Location Description: SAN BENITO COUNTY ABOUT 32 MILES SOUTH OF HOLLISTER FROM 0.8 MILE NORTH OF SAN BENITO LATERAL TO 2 MILES SOUTH OF ROUTE 146
Contractor Name: A. TEICHERT & SON, INC. DBA TEICHERT CONSTRUCTION
Contractor Address: 5200 Franklin Dr. Ste 115, Pleasanton, CA 94588
Resident Engineer: Baljinder S Brar Structure Rep.: Unknown
DIME Sample ID: 2023-11-04-16
TL Number from the TL Form:
Sample Submitted By Organization: CT D05 - Monterey Construction Field Laboratory
Sample Organization Contact: 831-818-0254
Type of Sample: Quality Assurance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 11/04/2023
Date that the sample was received by the laboratory/organization performing the testing: 11/07/2023
The quantity of what the sample constitutes: 1 JG
A brief description of the sample: SS-1H
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Northwest Oil - Stockton, CA
DIME Test ID: 2023-11-04-16-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 11/10/2023
Date Tested: 11/08/2023
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: 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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58.8 %
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Beaker 2 Residue
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58.6 %
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Percentage of residue
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59.0 %
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