Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993294 DEA: 061C2404 EFIS: 0621000034 MINOR: 06A2691
QA Service Level: 1
DIST-CO-RTE-PM: 06---
Work Description:
Location Description:
Contractor Name: Griffith Co.
Contractor Address: 12200 Bloomfield Ave, Santa Fe Springs, CA 90670
Resident Engineer: Sam Dhaliwal Structure Rep.: Unknown
DIME Sample ID: 2022-01-31-22
TL Number from the TL Form: 772533
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: 01/31/2022
Date that the sample was received by the laboratory/organization performing the testing: 02/02/2022
The quantity of what the sample constitutes: 1of2
A brief description of the sample: SS-IH ASPHALTIC EMULSION
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: VSS Emultech
DIME Test ID: 2022-01-31-22-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 02/04/2022
Date Tested: 02/02/2022
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
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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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43.4 %
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Beaker 2 Residue
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43.4 %
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Percentage of residue
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43.0 %
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