Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994561 DEA: 032G8604 EFIS: 0322000250
QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-80-R19.0/24.5
Work Description: RHMA, COLD PLANE AC PVMT, & MODIFYING TRAFFIC MONITORING STATIONS.
Location Description: PLACER COUNTY 0.6 MILE EAST OF AUBURN FROM 0.1 MILE EAST OF RUSSELL ROAD OVERCROSSING TO 1.1 MILES EAST OF PLACER HILLS OVERCROSSING
Contractor Name: GEORGE REED, INC.
Contractor Address: 2520 Warren Dr Rocklin CA 95677
Resident Engineer: Justing Kunert Structure Rep.: Unknown
DIME Sample ID: 2023-08-06-2
TL Number from the TL Form:
Sample Submitted By Organization: CT D03 - Rocklin Construction Field Office
Sample Organization Contact: 530-330-2727
Type of Sample: Acceptance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 08/06/2023
Date that the sample was received by the laboratory/organization performing the testing: 08/07/2023
The quantity of what the sample constitutes: 100 Tons
A brief description of the sample: ss-1h emulsion
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Northwest Oil
DIME Test ID: 2023-08-06-2-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 08/08/2023
Date Tested: 08/08/2023
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: Evap
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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2
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Beaker 1 Residue
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58.2 %
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Beaker 2 Residue
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58.2 %
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Percentage of residue
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58 %
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