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Sample Record for 2022-01-04-35

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 44444 DEA: ASCP EFIS: ASCP QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for Asphalt Supplier Certification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2022-01-04-35
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: Verification
Type of Material: Asphalt Binder
Sample Taken Date: 01/04/2022
Date that the sample was received by the laboratory/organization performing the testing: 02/10/2022
The quantity of what the sample constitutes: 2 OF 2
A brief description of the sample: Tank 3
From where was the sample collected: Manufacturer
Laboratory sample identification: 17206416012201
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Corona, CA

Material Information

Performance Grade: PG 64-16
Modified:
Lot number:
Sublot number:
Tank number: 3
Time of sample: 0800
HMA Supplier:
Certified Asphalt Supplier: Seventeen Twenty Oil Company - Corona CA
Multigrade: Yes
Multigrade Type: PG 64-16 / PG 64-10
Asphalt Binder Mix Number:
Test results on following page(s): 6

Test Results

Test 1 of 6

DIME Test ID: 2022-01-04-35-1
Test Method: AASHTO T51-13: Standard Method of Test for Ductility of Asphalt Materials (Asphalt Binder)
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
Data has not been verified.

Test 2 of 6

DIME Test ID: 2022-01-04-35-2
Test Method: AASHTO T315-20: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
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
Data has not been verified.

Test 3 of 6

DIME Test ID: 2022-01-04-35-3
Test Method: AASHTO T315-20: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
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
Data has not been verified.

Test 4 of 6

DIME Test ID: 2022-01-04-35-4
Test Method: AASHTO T315-20: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
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
Data has not been verified.

Test 5 of 6

DIME Test ID: 2022-01-04-35-5
Test Method: AASHTO T313-19: Standard Method of Test for Determining the Flexural Creep Stiffness of Asphalt Binder Using the Bending Beam Rheometer (BBR)
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
Data has not been verified.

Test 6 of 6

DIME Test ID: 2022-01-04-35-6
Test Method: AASHTO T315-20: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
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
Data has not been verified.