Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000090 DEA: 024J9204 EFIS: 0223000087
QA Service Level: 1
DIST-CO-RTE-PM: 02-TRI-299-61.0/64.0,70.0/72.2
Work Description: ASPHALT RUBBER CHIP SEAL WITH REPLACE ASPHALT CONCRETE SURFACING.
Location Description: TRINITY COUNTY NEAR DOUGLAS CITY FROM STEEL BRIDGE ROAD TO 1.5 MILES WEST OF GRASS VALLEY CREEK BRIDGE NO 05-0013 AND FROM 2.6 MILES EAST OF TRINITY DAM BOULEVARD TO THE SHASTA COUNTY LINE
Contractor Name: AMERICAN PAVEMENT SYSTEMS, INC.
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2024-08-06-106
TL Number from the TL Form: C854554
Sample Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Sample Organization Contact: (915) 296-1892
Type of Sample: Acceptance
Type of Material: Crumb Rubber Modifier
Sample Taken Date: 08/06/2024
Date that the sample was received by the laboratory/organization performing the testing: 08/16/2024
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: High Natural
From where was the sample collected: Source
Laboratory sample identification: 24-0144
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: American Tire Recycling
DIME Test ID: 2024-08-06-106-1
Test Method: CTM 385-July 2022: Method of Test for Crumb Rubber Modifier (CRM)
Verified Date: 08/29/2024
Date Tested: 08/23/2024
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: ryan.kester@dot.ca.gov
Organization Phone: (916) 227-7215
General Comments for this Test: Percent Fabric is 0.39% as per Test Method. Dime needs update.
Test Result Compliance:
Additional Comments When Verified:
|
Fabric in CRM
|
0.41 %
|
|
Wire in CRM
|
0.04 %
|
