Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994247 DEA: 051H8604 EFIS: 0517000002
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-46.2/R52.3
Work Description: COLD PLANE AC PVMT, PLACE HMA, RHMA-G, HMA-0, REPLACE MEDIAN BARRIER.
Location Description: SANTA BARBARA COUNTY NEAR GAVIOTA FROM 0.1 MILE NORTH OF GAVIOTA BEACH STATE PARK TO OLD COAST HIGHWAY
Contractor Name: CALPORTLAND COMPANY
Contractor Address: 1625 E DONOVAN RD, SANTA MARIA, CA 93456
Resident Engineer: Jason Torres Structure Rep.: Sal Heredia
DIME Sample ID: 2023-09-14-27
TL Number from the TL Form: 230914A
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: 09/14/2023
Date that the sample was received by the laboratory/organization performing the testing: 09/15/2023
The quantity of what the sample constitutes: 1 Jar of 2
A brief description of the sample: EMULSION
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: VSS Emultech West Sac
DIME Test ID: 2023-09-14-27-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 09/20/2023
Date Tested: 09/20/2023
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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62.2 %
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Beaker 2 Residue
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62.4 %
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Percentage of residue
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62 %
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