Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995146 DEA: 061G1104 EFIS: 0623000147
QA Service Level: 1
DIST-CO-RTE-PM: 06-KIN-43-10.2/18.2
Work Description: Modifying signal and lighting systems.
Location Description: In Kings County near Hanford from 0.2 mile south of Kansas Avenue to route 43/198 separation.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Ryan Wilson Structure Rep.: Unknown
DIME Sample ID: 2023-09-27-54
TL Number from the TL Form: C000001
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Quality Assurance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 09/27/2023
Date that the sample was received by the laboratory/organization performing the testing: 10/03/2023
The quantity of what the sample constitutes: I JUG OF EMULSION
A brief description of the sample: BWC
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Talley Oil - Madera
DIME Test ID: 2023-09-27-54-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 10/04/2023
Date Tested: 10/04/2023
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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63.4 %
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Beaker 2 Residue
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63.4 %
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Percentage of residue
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63 %
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