Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214976 DEA: 051G9904 EFIS: 0516000010
QA Service Level: 1
DIST-CO-RTE-PM: 05-SCR-129-1.2/1.6
Work Description: CONSTRUCT ROUNDABOUT.
Location Description: SANTA CRUZ COUNTY NEAR WATSONVILLE FROM 0.2 MILE EAST TO 0.2 MILE WEST OF LAKEVIEW ROAD
Contractor Name: Dreambuilder Construction Corporation
Contractor Address: 18543 YORBA LINDA BLVD # 376;, YORBA LINDA CA 92886
Resident Engineer: Ian Nguyen Structure Rep.: Unknown
DIME Sample ID: 2021-11-24-15
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Acceptance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 11/24/2021
Date that the sample was received by the laboratory/organization performing the testing: 11/30/2021
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: Graniterock
DIME Test ID: 2021-11-24-15-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 12/01/2021
Date Tested: 11/30/2021
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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57.2 %
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Beaker 2 Residue
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56.8 %
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Percentage of residue
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57.0 %
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