Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995037 DEA: 061E8004 EFIS: 0622000086
QA Service Level: 1
DIST-CO-RTE-PM: 06-TUL-63-21.7/R24.3
Work Description: PLACE SLURRY SEAL, THERMOPLASTIC TRAFFIC STRIPE AND PAVEMENT MARKING.
Location Description: TULARE COUNTY IN CUTLER AND OROSI FROM 0.1 MILE SOUTH OF AVENUE 402 TO AVENUE 422
Contractor Name: VSS INTERNATIONAL, INC.
Contractor Address: 3785 Channel Drive, West Sacramento, CA 95691
Resident Engineer: Tyler Street Structure Rep.: Unknown
DIME Sample ID: 2024-05-29-69
TL Number from the TL Form: C754872
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: 05/29/2024
Date that the sample was received by the laboratory/organization performing the testing: 06/11/2024
The quantity of what the sample constitutes: 2 jar of PMCQS-1H
A brief description of the sample: PMCQS-1H
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: VSS Emultech
DIME Test ID: 2024-05-29-69-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 06/12/2024
Date Tested: 06/12/2024
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: 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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64.2 %
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Beaker 2 Residue
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64.2 %
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Percentage of residue
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64 %
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