Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993555 DEA: 061C4304 EFIS: 0621000166
QA Service Level: 1
DIST-CO-RTE-PM: 06-MAD-41,99-9.2/11.7,0.0/1.5
Work Description: COLD PLANE AC, PLACE RHMA-G AND HMA (TYPE A).
Location Description: MADERA COUNTY NEAR MADERA ON ROUTE 41 FROM 0.7 MILE SOUTH OF ROAD 209 TO 0.3 MILE NORTH OF ROAD 208 AND ON ROUTE 99 FROM MADERA COUNTY LINE TO 0.7 MILE SOUTH OF AVENUE 8 OVERCROSSING
Contractor Name: CAL VALLEY CONSTRUCTION INC.
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2022-09-13-32
TL Number from the TL Form: 027152
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: 09/13/2022
Date that the sample was received by the laboratory/organization performing the testing: 09/22/2022
The quantity of what the sample constitutes: 1 jug
A brief description of the sample: SS-1H
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: 2022-09-13-32-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 09/26/2022
Date Tested: 09/22/2022
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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37.2 %
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Beaker 2 Residue
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37.4 %
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Percentage of residue
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37 %
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