Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993471 DEA: 061C4604 EFIS: 0621000168
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-223-R10.6/R20.1
Work Description: RESURFACE WITH HMA (TYPE A) AND POLYMER ASPHALT EMULSION SEAL COAT.
Location Description: KERN COUNTY NEAR ARVIN FROM ROUTE 223/99 SEPARATION TO COMANCHE DRIVE
Contractor Name: AMERICAN PAVEMENT SYSTEMS , Inc.
Contractor Address: 1012 11th Street #1000, Modesto, CA 95354
Resident Engineer: Amarjit Dhaliwal Structure Rep.: Unknown
DIME Sample ID: 2022-05-04-26
TL Number from the TL Form: C772550
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: 05/04/2022
Date that the sample was received by the laboratory/organization performing the testing: 05/10/2022
The quantity of what the sample constitutes: 1 OF 2 BOTTLES
A brief description of the sample: EMULSION
From where was the sample collected: Other
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: TALLY OIL INC
DIME Test ID: 2022-05-04-26-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 05/12/2022
Date Tested: 05/11/2022
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: complies
Additional Comments When Verified:
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How many beakers will be used to conduct the test?
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4
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Beaker 1 Residue
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57.0 %
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Beaker 2 Residue
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56.2 %
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Beaker 3 Residue
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56.6 %
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Beaker 4 Residue
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56.6 %
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Percentage of residue
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57.0 %
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