Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215420 DEA: 060R2104 EFIS: 0614000058
QA Service Level: 1
DIST-CO-RTE-PM: 06-MAD-41-6.2/9.2
Work Description: FOR CONSTRUCTION ON STATE HIGHWAY IN MADERA COUNTY NEAR MADERA FROM 0.1 MILE NORTH OF AVENUE 15 TO 2.2 MILES NORTH OF FRIANT MADERA CANAL BRIDGE
Location Description: MADERA COUNTY NEAR MADERA FROM 0.1 MILE NORTH OF AVENUE 15 TO 2.2 MILES NORTH OF FRIANT MADERA CANAL BRIDGE
Contractor Name: CAL VALLEY CONSTRUCTION
Contractor Address: 5125 N. Gates Ave, Ste 102, Fresno, CA 93722
Resident Engineer: Ryan Wilson Structure Rep.: Ramandeep Guraya
DIME Sample ID: 2024-06-24-74
TL Number from the TL Form: C0000103
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Acceptance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 06/24/2024
Date that the sample was received by the laboratory/organization performing the testing: 07/01/2024
The quantity of what the sample constitutes: 1 jar
A brief description of the sample: SS-1H 80/20
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: MAVERA TALTEY OIL
DIME Test ID: 2024-06-24-74-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 07/03/2024
Date Tested: 07/03/2024
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: 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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42 %
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Beaker 2 Residue
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42.4 %
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Beaker 3 Residue
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42.6 %
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Beaker 4 Residue
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42.2 %
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Percentage of residue
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42 %
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