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Sample Record for 2023-12-12-25

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 993905 DEA: 034H5814 EFIS: 0320000240 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-5-27.6/29.5,30.4/34.3
Work Description: ROADWAY EXCAVATION, PLACE CL2 AB, HMA & RHMA, & MODIFY RAMP METERS.
Location Description: SACRAMENTO COUNTY IN AND NEAR SACRAMENTO FROM 0.5 MILES SOUTH OF ARENA BOULEVARD OVERCROSSING TO 0.4 MILES SOUTH OF 99/5 INTERCHANGE AND FROM 0.5 MILES NORTH OF THE 99/5 INTERCHANGE TO 0.4 MILE SOUTH OF THE YOLO COUNTY LINE
Contractor Name: DeSILVA GATES CONSTRUCTION
Contractor Address: 3855 N Freeway, Ste. 100, Sacramento, CA 95834
Resident Engineer: Hani Eissa Structure Rep.: Brent Bullard

Sample Information

DIME Sample ID: 2023-12-12-25
TL Number from the TL Form:
Sample Submitted By Organization: Blackburn Consulting
Sample Organization Contact: (916) 375-8706
Type of Sample: Quality Assurance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 12/12/2023
Date that the sample was received by the laboratory/organization performing the testing: 12/14/2023
The quantity of what the sample constitutes: 1 Oil Jug
A brief description of the sample: Tack Coat
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Northwest Oil

Material Information

Emulsion Grade: SS-1h
Lot Number:
Sub Lot:
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2023-12-12-25-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 12/15/2023
Date Tested: 12/15/2023
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: Evap
Test Result Compliance: complies
Additional Comments When Verified:
How many beakers will be used to conduct the test? 2
Beaker 1 Residue 58.0 %
Beaker 2 Residue 58.0 %
Percentage of residue 58 %