Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000158 DEA: 033G0304 EFIS: 0323000117
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-160-L1.4/L7.0
Work Description: COLD PLANE AC PVMT, HMA, & RHMA.
Location Description: SACRAMENTO COUNTY NEAR ANTIOCH FROM 0.1 MILE NORTH OF ANTIOCH BRIDGE TO SHERMAN ISLAND EAST LEVEE ROAD
Contractor Name: ALL-AMERICAN CONSTRUCTION, INC.
Contractor Address: 1700 Acacia Avenue, Sutter, CA 95982
Resident Engineer: Mohssen Ghassemi Structure Rep.: Unknown
DIME Sample ID: 2024-09-05-30
TL Number from the TL Form: 849415
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Quality Assurance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 09/05/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/06/2024
The quantity of what the sample constitutes: 1 jar
A brief description of the sample: SS-1H emulsion TACK OIL
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: 2024-09-05-30-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 09/09/2024
Date Tested: 09/09/2024
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:
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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30.4 %
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Beaker 2 Residue
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29.6 %
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Percentage of residue
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30 %
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