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Sample Record for 2025-04-25-15

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Project Information

Project ID: 214135 DEA: 09213404 EFIS: 0900000030 QA Service Level: 1
DIST-CO-RTE-PM: 09-INY-395-29.9/41.8
Work Description: ROADWAY EXCAVATION, PLACE HMA (TYPE A), AND ALTERNATIVE PIPE CULVERT.
Location Description: INYO COUNTY NEAR OLANCHA AND CARTAGO FROM 1.4 MILES SOUTH OF LOS ANGELES AQUEDUCT BRIDGE TO 0.2 MILE SOUTH OF ASH CREEK BRIDGE
Contractor Name: FISHER SAND & GRAVEL CO.
Contractor Address: 1302 W DRIVERS WAY, TEPE, AZ. 85284
Resident Engineer: Kris Raber Structure Rep.: Sheila Reyes

Sample Information

DIME Sample ID: 2025-04-25-15
TL Number from the TL Form: JMF-02
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 04/25/2025
Date that the sample was received by the laboratory/organization performing the testing: 04/25/2025
The quantity of what the sample constitutes: JMF Verification
A brief description of the sample: 1/2" Coldfeed
From where was the sample collected: Source
Laboratory sample identification: 4572
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Fisher Sand and Gravel

Material Information

Source Identification (SMARA, name of Pit or Job Site): 00-00-0000
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: Sample Device at Plant
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:
Sublot number:
Aggregate Mix Number:
Test results on following page(s): 5

Test Results

Test 1 of 5

DIME Test ID: 2025-04-25-15-1
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)
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
Data has not been verified.

Test 2 of 5

DIME Test ID: 2025-04-25-15-2
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
Data has not been verified.

Test 3 of 5

DIME Test ID: 2025-04-25-15-3
Test Method: AASHTO T304-11: Standard Method of Test for Uncompacted Void Content of Fine Aggregate (Fine of Crushed Particles)
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
Data has not been verified.

Test 4 of 5

DIME Test ID: 2025-04-25-15-4
Test Method: AASHTO T335-09r13: Standard Method of Test for Determining the Percentage of Fracture in Coarse Aggregate (Percent of Crushed Particles)
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
Data has not been verified.

Test 5 of 5

DIME Test ID: 2025-04-25-15-5
Test Method: AASHTO T96-02r10: Standard Method of Test for Resistance to Degradation of Small-Size Coarse Aggregate by Abrasion and Impact in the Los Angeles Machine (Los Angeles Rattler)
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
Data has not been verified.