Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215041 DEA: 031J1904 EFIS: 0320000169
QA Service Level: 1
DIST-CO-RTE-PM: 03-YUB,YUB/SUT-70,70,99-Var
Work Description: In-kind restoration pvmt. repair w/HMA medium overlay, striping, traffic control, incidental work
Location Description: Yubat & Sutter Counties at various locaitons
Contractor Name: George Reed INC
Contractor Address: 140 Empire Avenue, Modesto, CA 95354
Resident Engineer: Donald Ward Structure Rep.: Unknown
DIME Sample ID: 2020-08-11-28
TL Number from the TL Form: 788960
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: 08/11/2020
Date that the sample was received by the laboratory/organization performing the testing: 08/11/2020
The quantity of what the sample constitutes: 1 jug
A brief description of the sample: Ashalt Emulsion
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: VSS Emultech
DIME Test ID: 2020-08-11-28-1
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:
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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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62.8 %
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Beaker 2 Residue
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62.8 %
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Beaker 3 Residue
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62.6 %
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Beaker 4 Residue
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62.8 %
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Percentage of residue
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62.8 %
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