Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214492 DEA: 033F5404 EFIS: 0313000136
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-99,160-4.5/5.7,R44.5
Work Description: FURNISH PRECAST PRESTRESSED CONCRETE SLAB & PLACE STRUCTURAL CONCRETE.
Location Description: SACRAMENTO COUNTY NEAR GALT ON ROUTE 99 FROM NORTH OF MINGO ROAD TO SOUTH OF ARNO ROAD OVERCROSSING AND IN SACRAMENTO ON ROUTE 160 AT AMERICAN RIVER BRIDGE
Contractor Name: BROSAMER & WALL, INC.
Contractor Address: 5000 Marsh Drive, Suite 300, Conord, CA 94520
Resident Engineer: Mohssen Ghassemi Structure Rep.: Chris Quon
DIME Sample ID: 2021-09-23-25
TL Number from the TL Form: c789526
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: 09/23/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/24/2021
The quantity of what the sample constitutes: 1 jug
A brief description of the sample: SS-1h
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: unknown
DIME Test ID: 2021-09-23-25-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Residue and Oil Distillate (Sec. 6))
Verified Date: 10/06/2021
Date Tested: 09/28/2021
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:
What parameters are being calculated?
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Percentage of oil residue
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Is this a polymer-modified emulsion
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No
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Percentage of oil residue
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55.3 %
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