Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993427 DEA: 061C4004 EFIS: 0621000165
QA Service Level: 1
DIST-CO-RTE-PM: 06-TUL-198,245-37.5/41.3,6.0/8.1
Work Description: COLD PLANE AC PAVEMENT, HMA (TYPE A), SLURRY SEAL, AND STRIPING.
Location Description: TULARE COUNTY NEAR THREE RIVERS ON ROUTE 198 FROM 0.3 MILE EAST OF THREE RIVERS DRIVE TO ROAD TO SAINT ANTHONY AND IN WOODLAKE ON ROUTE 245 FROM SAINT JOHNS RIVER TO CAJON AVENUE
Contractor Name: VSS International Inc.
Contractor Address: 3785 Channel Dr., West Sacramento CA, 95691
Resident Engineer: Haidar Haddadin Structure Rep.: Unknown
DIME Sample ID: 2022-04-18-31
TL Number from the TL Form: c039870
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Quality Assurance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 04/18/2022
Date that the sample was received by the laboratory/organization performing the testing: 04/22/2022
The quantity of what the sample constitutes: 1 jug tack coat
A brief description of the sample: ss1h 70/30
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Standard Emulsions - Visalia
DIME Test ID: 2022-04-18-31-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
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.
