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Sample Record for 2019-12-03-2

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 99999 DEA: 0322222 QA Service Level:
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Michael Maksimovich Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-12-03-2
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Quality Control
Type of Material: Asphaltic Emulsion
Sample Taken Date: 12/03/2019
Date that the sample was received by the laboratory/organization performing the testing: 12/03/2019
The quantity of what the sample constitutes: 2
A brief description of the sample: fdfsa
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Rock

Material Information

Emulsion Grade: SS1h
Lot Number: 1
Sub Lot: 2

Test Results

Test 1 of 3

DIME Test ID: 2019-12-03-2-1
Test Method: CTM 330-September 2017: Method of Test for Residue by Evaporation of Emulsified Asphalt
Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Organization Address: 5900 Folsom Boulevard, Room 225,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (916) 227-7302
Data has not been verified.

Test 2 of 3

DIME Test ID: 2019-12-03-2-2
Test Method: CTM 331-September 2017: Method of Test for Residue by Evaporation of Latex Modified Asphalt Emulsion
Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Organization Address: 5900 Folsom Boulevard, Room 225,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (916) 227-7302
Data has not been verified.

Test 3 of 3

DIME Test ID: 2019-12-03-2-3
Test Method: CTM 330-September 2017: Method of Test for Residue by Evaporation of Emulsified Asphalt
Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Organization Address: 5900 Folsom Boulevard, Room 225,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (916) 227-7302
Data has not been verified.