Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000301 DEA: 07333704 EFIS: 0716000316
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-138-43.4/51.4
Work Description: CONSTRUCT ADA CURB RAMPS, SIDEWALK, AND DRIVEWAY.
Location Description: LOS ANGELES COUNTY IN PALMDALE FROM ROUTE 14 JUNCTION (SOUTH) TO AVENUE T
Contractor Name: A. M. CONCRETE, INC.
Contractor Address: 3075 Townsgate Road, Suite 200, Westlake Village, CA 91361
Resident Engineer: Roberto Martinez Structure Rep.: Unknown
DIME Sample ID: 2025-02-21-39
TL Number from the TL Form: NA
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 02/21/2025
Date that the sample was received by the laboratory/organization performing the testing: 03/24/2025
The quantity of what the sample constitutes: 130 CY
A brief description of the sample: 3/4 HMA core
From where was the sample collected: Job Site
Laboratory sample identification: 25-039
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AM Concrete
DIME Test ID: 2025-02-21-39-1
Test Method: AASHTO T275-07r12: Standard Method of Test for Bulk Specific Gravity (Gmb) of Compacted Asphalt Mixtures Using Paraffin-Coated Specimens (Bulk Specific Gravity)
Verified Date: 03/26/2025
Date Tested: 03/26/2025
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 407-6963
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
|
Bulk Specific Gravity
|
2.308
|
