Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000095 DEA: 033G0204 EFIS: 0323000116
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-12-0.8/6.1
Work Description: COLD PLANE AND PLACE HMA-A, REMOVE AND INSTALL LANE SEPARATION SYSTEM.
Location Description: SACRAMENTO COUNTY NEAR ISLETON FROM 0.2 MILE EAST OF ROUTE 160 TO 0.1 MILE WEST OF SAN JOAQUIN COUNTY LINE
Contractor Name: O.C. JONES & SONS, INC.
Contractor Address: 1520 4th Street, Berkeley, CA 94710
Resident Engineer: Mohssen Ghassemi Structure Rep.: Mohssen Ghassemi
DIME Sample ID: 2024-07-10-36
TL Number from the TL Form: C849406
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: 07/10/2024
Date that the sample was received by the laboratory/organization performing the testing: 07/12/2024
The quantity of what the sample constitutes: 1 jar
A brief description of the sample: SS-1H 1jug emulsion
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Unknown
DIME Test ID: 2024-07-10-36-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 07/16/2024
Date Tested: 07/15/2024
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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59.6 %
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Beaker 2 Residue
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60 %
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Percentage of residue
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60 %
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