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Sample Record for 2024-10-07-26

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

Project Information

Project ID: 995005 DEA: 060X7004 EFIS: 0619000009 QA Service Level: 1
DIST-CO-RTE-PM: 06-TUL-63-5.8/L8.0
Work Description: COLD PLANE PAVEMENT, PLACE RHMA-G, MODIFY LIGHTING AND SIGNAL SYSTEM.
Location Description: TULARE COUNTY IN VISALIA FROM 0.2 MILE SOUTH OF CALDWELL AVENUE TO ROUTE 63/198 SEPARATION
Contractor Name: CAL VALLEY CONSTRUCTION, INC. (Angel Sandoval & Chris Grimm)
Contractor Address: 5125 N. Gates Ave, Suite 102, Fresno, CA 93722
Resident Engineer: Cesar Mandujano Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2024-10-07-26
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Visalia Field Laboratory
Sample Organization Contact: (559) 974-1304
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 10/07/2024
Date that the sample was received by the laboratory/organization performing the testing: 10/08/2024
The quantity of what the sample constitutes: 10 Box, 4 Bag, 2 Can
A brief description of the sample: 1/2 HMA Type A
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Deer Creek Rock and Aspahlt

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-54-0021
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: HMA Plant Cold Feed
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number: 1
Sublot number: 6
Aggregate Mix Number:
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2024-10-07-26-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 10/09/2024
Date Tested: 10/09/2024
Submitted By Organization: CT D06 - Visalia Field Laboratory
Organization Address: 8530 W Roosevelt Ave,
Organization City: Visalia
Organization State: CA
Organization Zipcode: 93291
Organization Email: paul.klinker@dot.ca.gov
Organization Phone: (559) 974-1304
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
What type of gradation is being tested? HMA Gradation
Cumulative percent passing the 2 in. sieve no data
Cumulative percent passing the 1 1/2 in. sieve 100 %
Cumulative percent passing the 1 in. sieve 100 %
Cumulative percent passing the 3/4 in. sieve 100 %
Cumulative percent passing the 1/2 in. sieve 94 %
Cumulative percent passing the 3/8 in. sieve 86 %
Cumulative percent passing the #4 sieve 59 %
Cumulative percent passing the #8 sieve 35 %
Cumulative percent passing the #16 sieve 20 %
Cumulative percent passing the #30 sieve 14 %
Cumulative percent passing the #50 sieve 9 %
Cumulative percent passing the #100 sieve 6 %
Cumulative percent passing the #200 sieve 5 %

Test 2 of 3

DIME Test ID: 2024-10-07-26-2
Test Method: AASHTO T176-08: Standard Method of Test for Plastic Fines in Graded Aggregates and Soils by Use of the Sand Equivalent Test (Sand Equivalent)
Verified Date: 10/09/2024
Date Tested: 10/08/2024
Submitted By Organization: CT D06 - Visalia Field Laboratory
Organization Address: 8530 W Roosevelt Ave,
Organization City: Visalia
Organization State: CA
Organization Zipcode: 93291
Organization Email: paul.klinker@dot.ca.gov
Organization Phone: (559) 974-1304
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Sand Equivalent 80

Test 3 of 3

DIME Test ID: 2024-10-07-26-3
Test Method: AASHTO T11-5: Standard Method of Test for Materials Finer Than 75-μm (No. 200) Sieve in Mineral Aggregates by Washing
Verified Date: 10/09/2024
Date Tested: 10/08/2024
Submitted By Organization: CT D06 - Visalia Field Laboratory
Organization Address: 8530 W Roosevelt Ave,
Organization City: Visalia
Organization State: CA
Organization Zipcode: 93291
Organization Email: paul.klinker@dot.ca.gov
Organization Phone: (559) 974-1304
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
Which test procedure is being used Method A
Percent of sample passing the #200 sieve (by mass) 7.1 %