Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212496 DEA: 024E4504 EFIS: 0200020286
QA Service Level: 1
DIST-CO-RTE-PM: 02-LAS,MOD-139,299-VAR
Work Description: PLACE HMA, REPLACE DRAINAGE, CULVERT, ELECTRICAL AND LIGHTING SYSTEMS.
Location Description: LASSEN AND MODOC COUNTIES ON ROUTE 139 AT 0.1 MILE NORTH OF LASSEN COUNTY LINE AND ON ROUTE 299 AT VARIOUS LOCATONS FROM 0.4 MILE WEST OF BOYD HILL LOOKOUT ROAD TO 0.6 MILE EAST OF COUNTY ROAD 87
Contractor Name: PAR ELECTRICAL CONTRACTORS INC
Contractor Address: 1465 WEST FOURTH STREET, RENO, NV 89503
Resident Engineer: Mike Zdenek Structure Rep.: Chris Brace
DIME Sample ID: 2021-10-29-27
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: Department Acceptance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 10/29/2021
Date that the sample was received by the laboratory/organization performing the testing: 12/02/2021
The quantity of what the sample constitutes: 1
A brief description of the sample: CQS-1 Emulsion
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: KLAMATH FALLS, OR
DIME Test ID: 2021-10-29-27-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 12/03/2021
Date Tested: 12/02/2021
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: pass
How many beakers will be used to conduct the test?
|
2
|
Beaker 1 Residue
|
62.8 %
|
Beaker 2 Residue
|
62.8 %
|
Percentage of residue
|
63.0 %
|