Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994975 DEA: 034H0704 EFIS: 0318000158
QA Service Level: 1
DIST-CO-RTE-PM: 03-NEV-20-R12.2/20.0
Work Description: COLD PLANE AND OVERLAY, INSTALL CURED-IN-PLACE PIPELINERS.
Location Description: NEVADA COUNTY IN AND NEAR GRASS VALLEY AND NEVADA CITY FROM ROUTE 20/49 SEPARATION TO 0.1 MILE EAST OF CELIO ROAD
Contractor Name: DESILVA GATES CONSTRUCTION LLC
Contractor Address: 3855 N Freeway, Ste. 100, Sacramento, CA 95834
Resident Engineer: Renee Plaza Structure Rep.: Unknown
DIME Sample ID: 2024-06-16-18
TL Number from the TL Form:
Sample Submitted By Organization: Blackburn Consulting
Sample Organization Contact: (916) 375-8706
Type of Sample: Quality Assurance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 06/16/2024
Date that the sample was received by the laboratory/organization performing the testing: 06/20/2024
The quantity of what the sample constitutes: 1 Bottle
A brief description of the sample: 3/4" RHMA-G, PG 64-16
From where was the sample collected: Source
Laboratory sample identification: 3802
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: DeSilva Gates Construction
DIME Test ID: 2024-06-16-18-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 06/25/2024
Date Tested: 06/21/2024
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:
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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58.4 %
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Percentage of residue
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59 %
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