Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994400 DEA: 09378904 EFIS: 0919000003
QA Service Level: 1
DIST-CO-RTE-PM: 09-KER-14-46.2/52.8
Work Description: RHMA PLACED OVER PARTIAL DEPTH RECYCLING.
Location Description: KERN COUNTY NEAR ARMISTEAD FROM 1.1 MILES NORTH OF REDROCK CANYON ROAD TO 3.5 MILES SOUTH OF FREEMAN GULCH BRIDGE
Contractor Name: STATEWIDE TRAFFIC SIGN AND SAFETY
Contractor Address: 4400 State Road, Bakersfield, CA 93308
Resident Engineer: Damon Cherenzia Structure Rep.: Unknown
DIME Sample ID: 2023-05-16-81
TL Number from the TL Form:
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Department Acceptance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 05/16/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/22/2023
The quantity of what the sample constitutes: 1 bottle
A brief description of the sample: Fog Seal
From where was the sample collected: Source
Laboratory sample identification: FS-2
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Western Emulsions
DIME Test ID: 2023-05-16-81-1
Test Method: CTM 330-September 2017: Method of Test for Residue by Evaporation of Emulsified Asphalt
Verified Date: 06/27/2023
Date Tested: 06/27/2023
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
