Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994729 DEA: 034H88U4 EFIS: 0323000024
QA Service Level: 1
DIST-CO-RTE-PM: 03-BUT-32-0.3/5.0
Work Description: INSTALL LIGHTING, WIDEN SHLD, UPGRADE END TREATMENTS, EXTEND CULVERTS.
Location Description: BUTTE COUNTY NEAR CHICO FROM 0.3 MILE EAST OF BUTTE COUNTY LINE TO MUIR AVENUE
Contractor Name: BALDWIN CONTRACTING COMPANY INC. DBA KNIFE RIVER CONSTRUCTION
Contractor Address: 1764 SKYWAY, CHICO, CA 95928
Resident Engineer: Dustin Watts Structure Rep.: Nicholas McLean
DIME Sample ID: 2023-11-09-54
TL Number from the TL Form: 733608
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: 11/09/2023
Date that the sample was received by the laboratory/organization performing the testing: 11/14/2023
The quantity of what the sample constitutes: 1 Jar
A brief description of the sample: Tack oil ss-1h
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: 2023-11-09-54-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 11/15/2023
Date Tested: 11/15/2023
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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58.0 %
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Beaker 2 Residue
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58.0 %
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Percentage of residue
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58 %
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