Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 213411 DEA: 030H10U4 EFIS: 0317000246
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-5-9.7/24.9
Work Description:
Location Description: Construction on state highway in Sacramento County in and near Sacramento from 1.1 miles south of Elk Grove Boulevard to American River Viaduct
Contractor Name: NOR CAL PAVING TEICHERT/GRANITE
Contractor Address: 400 Sunrise Ave. Ste. #300, Roseville, CA 95661
Resident Engineer: Daniel Tecle Structure Rep.: Pha Tran
DIME Sample ID: 2022-07-14-40
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: Quality Assurance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 07/14/2022
Date that the sample was received by the laboratory/organization performing the testing: 07/18/2022
The quantity of what the sample constitutes: 1 jug
A brief description of the sample: SS-1H Emulsified Asphalt
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Northwest Oil - Stockton, CA
DIME Test ID: 2022-07-14-40-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 07/19/2022
Date Tested: 07/18/2022
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:
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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58.4 %
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Beaker 2 Residue
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58.0 %
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Percentage of residue
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58.0 %
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