Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994820 DEA: 060V1104 EFIS: 0616000208
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE,KIN-5,41,198-Var
Work Description: STRATFORD KINGS RIVER BRIDGE REPLACEMENT.
Location Description: FRESNO AND KINGS COUNTIES AT VARIOUS LOCATIONS
Contractor Name: M.C.M. Construction, INC. (Richard McCall)
Contractor Address: 6413 32nd Street, North Highlands, Ca 95660
Resident Engineer: Din Dadawalla Structure Rep.: Martin Garcia
DIME Sample ID: 2024-06-26-74
TL Number from the TL Form: None provided
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: 06/26/2024
Date that the sample was received by the laboratory/organization performing the testing: 07/01/2024
The quantity of what the sample constitutes: 1 bottle of emulsion
A brief description of the sample: CSS-1h 50/50
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: American Pavement Systems
DIME Test ID: 2024-06-26-74-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 07/02/2024
Date Tested: 07/02/2024
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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31.6 %
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Beaker 2 Residue
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32 %
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Percentage of residue
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32 %
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