Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215094 DEA: 101E5314 EFIS: 1016000031
QA Service Level: 1
DIST-CO-RTE-PM: 10-SJ-88-22.1
Work Description: PLACE HMA & INSTALL LIGHTING, FLASHING BEACON & CAMERA SYSTEMS.
Location Description: SAN JOAQUIN COUNTY NEAR CLEMENTS AT LIBERTY ROAD
Contractor Name: O.C. Jones & Sons, Inc.
Contractor Address: 1520 Fourth Street, Berkeley, CA 94710
Resident Engineer: Ariel Mendoza Structure Rep.: Unknown
DIME Sample ID: 2021-11-16-4
TL Number from the TL Form: 032114
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: 11/16/2021
Date that the sample was received by the laboratory/organization performing the testing: 11/16/2021
The quantity of what the sample constitutes: 1 jug
A brief description of the sample: ss1h
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Northwest Oil - Stockton, CA
DIME Test ID: 2021-11-16-4-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 11/17/2021
Date Tested: 11/16/2021
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: Per 2018 standard specifications
Test Result Compliance: complies
Additional Comments When Verified:
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How many beakers will be used to conduct the test?
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2
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Beaker 1 Residue
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59.2 %
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Beaker 2 Residue
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59.0 %
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Percentage of residue
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59.0 %
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