Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214993 DEA: 051F5004 EFIS: 0514000003
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101,135-70.6/71.2;0.1
Work Description: CONSTRUCT CONCRETE BRIDGE, BRIDGE REMOVAL, COLD PLANE, PLACE HMA.
Location Description: SANTA BARBARA COUNTY AT LOS ALAMOS ON ROUTE 101 FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF ROUTE 101/135 SEPARATION AND ON ROUTE 135 AT ROUTE 101/135 SEPARATION
Contractor Name: CAL PORTLAND CONSTRUCTION
Contractor Address: 1625 E Donovan Road, Santa Maria, CA 93454
Resident Engineer: Jason Torres Structure Rep.: Alex Martinez
DIME Sample ID: 2022-03-07-13
TL Number from the TL Form: C220307B
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: 03/07/2022
Date that the sample was received by the laboratory/organization performing the testing: 03/15/2022
The quantity of what the sample constitutes: 1 BOTTLE
A brief description of the sample: EMULSION
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: NOT PROVIDED
DIME Test ID: 2022-03-07-13-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 03/16/2022
Date Tested: 03/16/2022
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:
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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58.8 %
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Beaker 2 Residue
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58.6 %
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Percentage of residue
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59.0 %
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