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Sample Record for 2017-12-19-9

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

Project Information

Project ID: 99999 DEA: 0322222 QA Service Level:
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Michael Maksimovich Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2017-12-19-9
TL Number from the TL Form: TL 326120
Sample Submitted By Organization: CT HQ - QAM Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7266
Type of Sample: Quality Control
Type of Material: Asphalt Rubber Binder
Sample Taken Date: 12/19/2017
Date that the sample was received by the laboratory/organization performing the testing: 12/19/2017
The quantity of what the sample constitutes: TEST Quantity
A brief description of the sample: TEST Antistrip
From where was the sample collected: Other
Laboratory sample identification: Lab 326120
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CRM

Material Information

Asphalt modifier supplier: San Joaquin Refining Co Inc
Performance Grade:
Lot number:
Sublot number:
Asphalt Rubber Binder Mix Number:
Test results on following page(s): 5

Test Results

Test 1 of 5

DIME Test ID: 2017-12-19-9-1
Test Method: ASTM D217-16: Standard Test Methods for Cone Penetration of Lubricating Grease (Cone Penetration)
Verified Date: 12/19/2017
Date Tested: 12/19/2017
Submitted By Organization: CT HQ - QAM Sacramento Field Laboratory
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Determination Worked Penetration
Worked Penetration 39 0.1 mm

Test 2 of 5

DIME Test ID: 2017-12-19-9-2
Test Method: ASTM D217-16: Standard Test Methods for Cone Penetration of Lubricating Grease (Cone Penetration)
Verified Date: 12/19/2017
Date Tested: 12/19/2017
Submitted By Organization: CT HQ - QAM Sacramento Field Laboratory
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Determination Block Penetration
Block Penetration 39 0.1 mm
Minutes Reaction no data

Test 3 of 5

DIME Test ID: 2017-12-19-9-3
Test Method: ASTM D217-16: Standard Test Methods for Cone Penetration of Lubricating Grease (Cone Penetration)
Verified Date: 12/19/2017
Date Tested: 12/19/2017
Submitted By Organization: CT HQ - QAM Sacramento Field Laboratory
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Determination Unworked Penetration
Unworked Penetration 37 0.1 mm

Test 4 of 5

DIME Test ID: 2017-12-19-9-4
Test Method: ASTM D217-16: Standard Test Methods for Cone Penetration of Lubricating Grease (Cone Penetration)
Verified Date: 12/19/2017
Date Tested: 12/19/2017
Submitted By Organization: CT HQ - QAM Sacramento Field Laboratory
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Determination Block Penetration
Block Penetration 37 0.1 mm
Minutes Reaction no data

Test 5 of 5

DIME Test ID: 2017-12-19-9-5
Test Method: ASTM D217-16: Standard Test Methods for Cone Penetration of Lubricating Grease (Cone Penetration)
Verified Date: 12/19/2017
Date Tested: 12/19/2017
Submitted By Organization: CT HQ - QAM Sacramento Field Laboratory
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Determination Prolonged Worked Penetration
Prolonged Worked Penetration 36 0.1 mm