Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993407 DEA: 051N6204 EFIS: 0521000068
QA Service Level: 1
DIST-CO-RTE-PM: 05-MON,SBT-146-1.5/10.1,10.1/10.2
Work Description: PLACE POLYMER MODIFIED EMULSION CHIP SEAL COAT ON EXISTING ROADBED.
Location Description: MONTEREY AND SAN BENITO COUNTIES NEAR SOLEDAD FROM 0.1 MILE EAST OF RUBION DRIVE TO WEST BOUNDARY PINNACLES NATIONAL PARK
Contractor Name: NORTHWEST PAVING, INC
Contractor Address: 8115 SECLUDED VALLEY DRIVE;, REDDING CA 96001
Resident Engineer: BALJINDER BRAR Structure Rep.: Unknown
DIME Sample ID: 2022-07-25-52
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: Asphaltic Emulsion
Sample Taken Date: 07/25/2022
Date that the sample was received by the laboratory/organization performing the testing: 08/04/2022
The quantity of what the sample constitutes: 1 of jug
A brief description of the sample: PMCRS-2h Emulsion
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Talley Oil
DIME Test ID: 2022-07-25-52-1
Test Method: AASHTO T59-16: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 08/08/2022
Date Tested: 08/08/2022
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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64.6 %
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Beaker 2 Residue
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65.0 %
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Percentage of residue
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65.0 %
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