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Sample Record for 2021-04-19-2

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

Project Information

Project ID: 44444 DEA: ASCP EFIS: ASCP QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for Asphalt Supplier Certification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-04-19-2
TL Number from the TL Form:
Sample Submitted By Organization: Veleroo - Coolidge
Sample Organization Contact: 111-111-1111
Type of Sample: Quality Control
Type of Material: Asphalt Binder
Sample Taken Date: 04/19/2021
Date that the sample was received by the laboratory/organization performing the testing: 04/19/2021
The quantity of what the sample constitutes: 1 of 2, split sample
A brief description of the sample: Asphalt Binder PG64-16 Multi-Grade
From where was the sample collected: Fabricator
Laboratory sample identification: 641641621
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Ergon Asphalt and Emulsions

Material Information

Performance Grade: PG 64-16
Modified: No
Lot number:
Sublot number:
Tank number: 5
Time of sample: 0600
HMA Supplier:
Certified Asphalt Supplier: Ergon Asphalt & Emulsions Incorporated - Las Vegas NV
Multigrade: Yes
Multigrade Type:
Asphalt Binder Mix Number:
Test results on following page(s): 8

Test Results

Test 1 of 8

DIME Test ID: 2021-04-19-2-1
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: 04/19/2021
Date Tested: 04/19/2021
Submitted By Organization: Veleroo - Coolidge
Organization Address: 123 Abc Street,
Organization City: Coolidge
Organization State: AZ
Organization Zipcode: 88888
Organization Email: binderlab1@gmail.com
Organization Phone: (111) 111-1111
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Is mass change based on one or two containers? One
Average mass change -0.044 percent

Test 2 of 8

DIME Test ID: 2021-04-19-2-2
Test Method: AASHTO T51-13: Standard Method of Test for Ductility of Asphalt Materials (Asphalt Binder)
Verified Date: 04/19/2021
Date Tested: 04/19/2021
Submitted By Organization: Veleroo - Coolidge
Organization Address: 123 Abc Street,
Organization City: Coolidge
Organization State: AZ
Organization Zipcode: 88888
Organization Email: binderlab1@gmail.com
Organization Phone: (111) 111-1111
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Is a normal test obtainable? Yes
Number of replicates tested Three
Ductility of test #1 (D1) 120 cm
Ductility of test #2 (D2) 120 cm
Ductility of test #3 (D3) 120 cm
Ductility of sample 120 cm

Test 3 of 8

DIME Test ID: 2021-04-19-2-3
Test Method: AASHTO T315-16: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
Verified Date: 04/19/2021
Date Tested: 04/19/2021
Submitted By Organization: Veleroo - Coolidge
Organization Address: 123 Abc Street,
Organization City: Coolidge
Organization State: AZ
Organization Zipcode: 88888
Organization Email: binderlab1@gmail.com
Organization Phone: (111) 111-1111
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Phase Original binder
Test Plate Diameter 25 mm
Phase Angle (δ) (for the 10 cycles) 86.6 degree
Dynamic Shear, G*/sin(δ) 1.37 kPa

Test 4 of 8

DIME Test ID: 2021-04-19-2-4
Test Method: AASHTO T315-16: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
Verified Date: 04/19/2021
Date Tested: 04/19/2021
Submitted By Organization: Veleroo - Coolidge
Organization Address: 123 Abc Street,
Organization City: Coolidge
Organization State: AZ
Organization Zipcode: 88888
Organization Email: binderlab1@gmail.com
Organization Phone: (111) 111-1111
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Phase RTFO residue
Test Plate Diameter 25 mm
Phase Angle (δ) (for the 10 cycles) 42.7 degree
Dynamic Shear, G*/sin(δ) 2.50 kPa

Test 5 of 8

DIME Test ID: 2021-04-19-2-5
Test Method: AASHTO T315-16: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
Verified Date: 04/19/2021
Date Tested: 04/19/2021
Submitted By Organization: Veleroo - Coolidge
Organization Address: 123 Abc Street,
Organization City: Coolidge
Organization State: AZ
Organization Zipcode: 88888
Organization Email: binderlab1@gmail.com
Organization Phone: (111) 111-1111
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Phase PAV residue
Test Plate Diameter 8 mm
Phase Angle (δ) (for the 10 cycles) 54.3 degree
(G*) x sin(δ)= 4500 kPa

Test 6 of 8

DIME Test ID: 2021-04-19-2-6
Test Method: AASHTO T44-18: Standard Method of Test for Solubility of Bituminous Materials
Verified Date: 04/19/2021
Date Tested: 04/19/2021
Submitted By Organization: Veleroo - Coolidge
Organization Address: 123 Abc Street,
Organization City: Coolidge
Organization State: AZ
Organization Zipcode: 88888
Organization Email: binderlab1@gmail.com
Organization Phone: (111) 111-1111
General Comments for this Test: Secondary laboratory apart
Test Result Compliance:
Additional Comments When Verified:
Was test performed on residue from distillation or evaporation? Distillation
Soluble, percent 0.1 %
Insoluble, percent 99.9 %

Test 7 of 8

DIME Test ID: 2021-04-19-2-7
Test Method: AASHTO T313-19: Standard Method of Test for Determining the Flexural Creep Stiffness of Asphalt Binder Using the Bending Beam Rheometer (BBR)
Verified Date: 04/19/2021
Date Tested: 04/21/2021
Submitted By Organization: Veleroo - Coolidge
Organization Address: 123 Abc Street,
Organization City: Coolidge
Organization State: AZ
Organization Zipcode: 88888
Organization Email: binderlab1@gmail.com
Organization Phone: (111) 111-1111
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Time test started no data HH:MM:SS
Flags issued by software during test no data
Correlation coefficient (R²) 0
Regression coefficient a no data
Regression coefficient b no data
Regression coefficient c no data
Load at time 0.0 0.0 mN
Deflection at time 0.0 s 0.000 µm
Load at time 0.5 s 0.0 mN
Deflection at time 0.5 s 0.000 µm
Load at 60.0 s 0.0 mN
Beam deflection 60.0 s 0.000 µm
Measured Stiffness Modulus 60.0 s 210.000 mPa
Estimated Stiffness Modulus 60.0 s 210.000 mPa
Difference between stiffness moduli 60.0 s no data
Estimated m-value 60.0 s 0.330

Test 8 of 8

DIME Test ID: 2021-04-19-2-8
Test Method: AASHTO T228-09r13: Standard Method of Test for Specific Gravity of Semi-Solid Asphalt Materials (Specific Gravity)
Verified Date: 04/19/2021
Date Tested: 04/19/2021
Submitted By Organization: Veleroo - Coolidge
Organization Address: 123 Abc Street,
Organization City: Coolidge
Organization State: AZ
Organization Zipcode: 88888
Organization Email: binderlab1@gmail.com
Organization Phone: (111) 111-1111
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Specific Gravity 2.136