Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214802 DEA: 031G7004 EFIS: 0319000135
QA Service Level: 1
DIST-CO-RTE-PM: 03-SUT-99-28.0/30.6
Work Description: COLD PLANE AC PAVEMENT, RHMA OVERLAY, & INDUCTIVE LOOP DETECTORS.
Location Description: SUTTER COUNTY IN AND NEAR YUBA CITY FROM 0.1 MILE NORTH OF SMITH ROAD TO ROUTE 20
Contractor Name: DESILVA GATES CONSTRUCTION
Contractor Address: 3855 N Freeway Blvd. , Ste 105, Sacramento, CA 95834
Resident Engineer: Selvendran Manoharan Structure Rep.: Unknown
DIME Sample ID: 2020-08-12-16
TL Number from the TL Form: 593241
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Acceptance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 08/12/2020
Date that the sample was received by the laboratory/organization performing the testing: 08/25/2020
The quantity of what the sample constitutes: 1jug ss-1h
A brief description of the sample: ss-1h emulsion
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Northwest Oil
DIME Test ID: 2020-08-12-16-2
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 08/28/2020
Date Tested: 08/28/2020
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:
How many beakers will be used to conduct the test?
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4
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Beaker 1 Residue
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47.2 %
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Beaker 2 Residue
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47.4 %
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Beaker 3 Residue
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47.4 %
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Beaker 4 Residue
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47.6 %
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Percentage of residue
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47.4 %
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