Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215744 DEA: 033H93U4 EFIS: 0321000091
QA Service Level: 1
DIST-CO-RTE-PM: 03-YUB,BUT-70-25.5/25.8,0.0/3.8
Work Description: WIDEN ROADWAY & SHOULDER, ADD TURN LANES & CONSTRUCT BRIDGE.
Location Description: YUBA AND BUTTE COUNTIES ABOUT 11 MILES NORTH OF MARYSVILLE FROM 0.8 MILE NORTH OF CHANDLER ROAD TO 0.2 MILE SOUTH OF EAST GRIDLEY ROAD
Contractor Name: Teichert Construction & MCM JV
Contractor Address: 4401 Duluth Ave, Rocklin, CA 95766
Resident Engineer: Anthony Granados Structure Rep.: Matt Crete
DIME Sample ID: 2023-08-17-50
TL Number from the TL Form: 593019
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Department Acceptance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 08/17/2023
Date that the sample was received by the laboratory/organization performing the testing: 08/23/2023
The quantity of what the sample constitutes: 1 jug
A brief description of the sample: tack oil
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Northwest Oil
DIME Test ID: 2023-08-17-50-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 08/25/2023
Date Tested: 08/24/2023
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:
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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59.0 %
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Percentage of residue
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59 %
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