Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214710 DEA: 051J4704 EFIS: 0517000184
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-135-17.3/17.6
Work Description: BUNNY AVENUE AND NORTH BROADWAY PED IMPROVEMENTS
Location Description: SANTA BARBARA COUNTY IN SANTA MARIA AT BUNNY AVENUE AND FROM ROEMER WAY TO PREISKER LANE
Contractor Name: FEC Future Contractors & Engineers, Inc
Contractor Address: 184 Technology Dr., Ste 2, Irvine, CA 92618
Resident Engineer: Thomas Petersen Structure Rep.: Unknown
DIME Sample ID: 2021-12-06-24
TL Number from the TL Form: 211206B
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Verification
Type of Material: Asphaltic Emulsion
Sample Taken Date: 12/06/2021
Date that the sample was received by the laboratory/organization performing the testing: 12/10/2021
The quantity of what the sample constitutes: 1
A brief description of the sample: ss-1h
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Production Paving
DIME Test ID: 2021-12-06-24-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 12/14/2021
Date Tested: 12/13/2021
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:
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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31.2 %
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Beaker 2 Residue
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29.0 %
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Percentage of residue
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30.0 %
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