Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212246 DEA: 053307A4 EFIS: 0514000027
QA Service Level: 1
DIST-CO-RTE-PM: 05-SLO-46-49.7/54.6
Work Description: Cholame Segment
Location Description:
Contractor Name: Atkinson Construction
Contractor Address: 18201 Von Karman - Suite 800, Irvine, CA 92612
Resident Engineer: Andrew Borrelli Structure Rep.: Dave Lewis
DIME Sample ID: 2024-01-09-20
TL Number from the TL Form: C979515
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: 01/09/2024
Date that the sample was received by the laboratory/organization performing the testing: 01/12/2024
The quantity of what the sample constitutes: 1 Jar - Mix# L230077A
A brief description of the sample: Tack coat 3/4" HMA-A 15% RAP w/WMA
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: Paving
The fabricator/manufacturer/facility name: Papich Construction
DIME Test ID: 2024-01-09-20-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 01/18/2024
Date Tested: 01/16/2024
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 , no COC was included, SS1H by default, bottle received @ 2pm was very cold.
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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4
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Beaker 1 Residue
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59.8 %
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Beaker 2 Residue
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59.4 %
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Beaker 3 Residue
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60 %
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Beaker 4 Residue
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59.8 %
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Percentage of residue
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60 %
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