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Sample Record for 2025-04-10-20

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

Project Information

Project ID: 994443 DEA: 053307C4 EFIS: 0514000028 QA Service Level: 1
DIST-CO-RTE-PM: 05-SLO-41,46-44.5/45.3,54.0/57.8
Work Description: Wye Segment - Route 41/46 Separation
Location Description:
Contractor Name: Atkinson Construction
Contractor Address: 18201 Von Karman - Suite 800, Irvine, CA 92612
Resident Engineer: Brian Harrington Structure Rep.: Dave Lewis

Sample Information

DIME Sample ID: 2025-04-10-20
TL Number from the TL Form:
Sample Submitted By Organization: CT D05 - Whitley Gardens Field Laboratory
Sample Organization Contact: 805-540-9933
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 04/10/2025
Date that the sample was received by the laboratory/organization performing the testing: 04/11/2025
The quantity of what the sample constitutes: 13 tons
A brief description of the sample: 1 HMA core
From where was the sample collected: Job Site
Laboratory sample identification: 250410-L1SL4
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sierra Pacific Materials - Templeton

Material Information

HMA Type: RHMA-G
HMA Grading: 1/2 inch
Lot number: 1
Sublot number: 4
HMA Mix Number: L223535T
Binder content (%):
Virgin binder PG:
Design binder PG:
Binder Supplier:
RAP content (%):
WMA Additives:
Antistrip type:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2025-04-10-20-1
Test Method: AASHTO T209-22: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Verified Date: 04/15/2025
Date Tested: 04/11/2025
Submitted By Organization: CT D05 - Whitley Gardens Field Laboratory
Organization Address: 102 South Whitley Gardens Drive,
Organization City: Paso Robles
Organization State: CA
Organization Zipcode: 93346
Organization Email: kyle.engen@dot.ca.gov
Organization Phone: (805) 540-9933
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
Number of Samples 1
What is the unit of measurement for theoretical density? US Units
Mass Determination Water
Method Performed Mechanical Agitation - Method A
Mass of oven-dry sample in air for Sample 1 1526.8 grams
Mass of container submerged in water for Sample 1 1393 grams
Mass of the sample and container in water for Sample 1 2282.5 grams
Temperature of Water 77 °F
Specific Gravity for Sample 1 2.396
Theoretical maximum density at 25°C (77°F) 149.1 lb/ft^3

Test 2 of 2

DIME Test ID: 2025-04-10-20-2
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: 04/15/2025
Date Tested: 04/11/2025
Submitted By Organization: CT D05 - Whitley Gardens Field Laboratory
Organization Address: 102 South Whitley Gardens Drive,
Organization City: Paso Robles
Organization State: CA
Organization Zipcode: 93346
Organization Email: kyle.engen@dot.ca.gov
Organization Phone: (805) 540-9933
General Comments for this Test: L1SL4A 93.4%
Test Result Compliance: complies
Additional Comments When Verified:
Bulk Specific Gravity 2.237