Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215023 DEA: 060U4704 EFIS: 0615000301
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER,KIN-5-81.7/87.0,0.0/0.3
Work Description: CONSTRUCT CRCP, JPCP AND INSTALL TRAFFIC MONITORING STATIONS.
Location Description: KERN AND KINGS COUNTIES NEAR KETTELMAN CITY FROM 0.6 MILE SOUTH OF TWISSELMAN ROAD OVERCROSSING TO 0.3 MILE NORTH OF KERN/KINGS COUNTY LINE
Contractor Name: PAPICH CONSTRUCTION COMPANY, INC.
Contractor Address: P O BOX 2217, PISMO BEACH CA 93448
Resident Engineer: Din Dadawalla Structure Rep.: Unknown
DIME Sample ID: 2020-12-10-20
TL Number from the TL Form: c816379
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Department Acceptance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 12/10/2020
Date that the sample was received by the laboratory/organization performing the testing: 12/18/2020
The quantity of what the sample constitutes: 1 of 1
A brief description of the sample: 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: 2020-12-10-20-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 12/22/2020
Date Tested: 12/22/2020
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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51.2 %
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Beaker 2 Residue
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51.2 %
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Beaker 3 Residue
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51.2 %
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Beaker 4 Residue
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51.2 %
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Percentage of residue
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51.2 %
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