Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995124 DEA: 060X3004 EFIS: 0618000051
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-33-69.4/71.5
Work Description: REPLACE ROADWAY PAVEMENT.
Location Description: FRESNO COUNTY IN AND NEAR FIREBAUGH FROM MORRIS KYLE DRIVE TO LYON AVENUE
Contractor Name: BAY CITIES PAVING & GRADING, INC.
Contractor Address: 1450 Civic Court, Building B. #400, Concord, CA 94524
Resident Engineer: Din Dadawalla Structure Rep.: Benjamin Holton
DIME Sample ID: 2024-08-22-71
TL Number from the TL Form: Unknown
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: 08/22/2024
Date that the sample was received by the laboratory/organization performing the testing: 08/30/2024
The quantity of what the sample constitutes: 1 bottle of emulsion
A brief description of the sample: SS-1H EMULSION
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific northwest oil
DIME Test ID: 2024-08-22-71-1
Test Method: AASHTO T59-22: Standard Method of Test for Emulsified Asphalts (Emulsified Asphalt Residue Evap. (Sec. 7))
Verified Date: 09/05/2024
Date Tested: 09/05/2024
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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57.4 %
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Beaker 2 Residue
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57 %
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Percentage of residue
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57 %
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