Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994836 DEA: 032J9504 EFIS: 0322000142
QA Service Level: 1
DIST-CO-RTE-PM: 03-COL-20-R0.6/R1.2,3.4
Work Description: HMA (TYPE A), HIGH FRICTION SURFACE TREATMENT, & STBB.
Location Description: COLUSA COUNTY ABOUT 20 MILES WEST OF WILLIAMS FROM 0.6 MILE EAST TO 1.2 MILES EAST OF LAKE COUNTY LINE AND AT ROUTE 16
Contractor Name: MARTIN BROTHERS CONSTRUCTION
Contractor Address: 8801 Folsom Blvd. Ste. 260, Sacramento, CA 95826
Resident Engineer: Dwayne Grandy Structure Rep.: Unknown
DIME Sample ID: 2024-05-08-56
TL Number from the TL Form: 733610
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Verification
Type of Material: Asphaltic Emulsion
Sample Taken Date: 05/08/2024
Date that the sample was received by the laboratory/organization performing the testing: 05/14/2024
The quantity of what the sample constitutes: 1 jar
A brief description of the sample: SS-1H Tack Coat
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: A 126+00 TO A 146+00
The fabricator/manufacturer/facility name: Northwest Pacific Oil
DIME Test ID: 2024-05-08-56-2
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 05/16/2024
Date Tested: 05/16/2024
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
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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4
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Beaker 1 Residue
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55.4 %
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Beaker 2 Residue
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55.6 %
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Beaker 3 Residue
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56.2 %
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Beaker 4 Residue
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56.4 %
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Percentage of residue
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56 %
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