Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214725 DEA: 020J1304 EFIS: 0219000064
QA Service Level: 1
DIST-CO-RTE-PM: 02-LAS-139-43.0/53.0
Work Description: COLD IN-PLACE RECYCLING AND PLACE HMA (TYPE A).
Location Description: LASSEN COUNTY ABOUT 42 MILES NORTH OF SUSANVILLE FROM 3.8 MILES NORTH OF SLATE CREEK TO 4.7 MILES SOUTH OF WILLOW CREEK RANCH ROAD
Contractor Name: HAT CREEK CONSTRUCTION & MATERIALS, INC.
Contractor Address: 24339 STATE HIGHWAY 89 N.;, BURNEY CA 96013
Resident Engineer: Structure Rep.: Unknown
DIME Sample ID: 2020-05-21-30
TL Number from the TL Form: 733196
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Acceptance
Type of Material: Asphalt Binder
Sample Taken Date: 05/21/2020
Date that the sample was received by the laboratory/organization performing the testing: 06/05/2020
The quantity of what the sample constitutes: 1 Can, #1 Test
A brief description of the sample: Asphalt Binder
From where was the sample collected: Source
Laboratory sample identification: AB206042
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Albina - Klamath Falls, OR
Performance Grade: PG 58-34 M
Modified: Yes
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier:
Multigrade:
Multigrade Type:
Asphalt Binder Mix Number:
DIME Test ID: 2020-05-21-30-1
Test Method: AASHTO T240-17: Standard Method of Test for Effect of Heat and Air on a Moving Film of Asphalt Binder (Rolling Thin-Film Oven Test)
Verified Date: 07/01/2020
Date Tested: 07/01/2020
Submitted By Organization: CT HQ - Sacramento Asphalt Binder 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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Is mass change based on one or two containers?
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One
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Any material loss from containers during heating process/testing?
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No
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Mass of empty container #1
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173.780 grams
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Mass of container #1 before test (m1i)
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209.310 grams
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Mass of container #1 after test (m1f)
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209.190 grams
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Average mass change
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-0.338 percent
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