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Sample Record for 2025-05-30-31

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

Project Information

Project ID: 215365 DEA: 120Q9704 EFIS: 1218000010 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-405-0/11.4
Work Description: I-405 improvement project from I-5 to Harbor Boulevard including extend pavement life, improve safety, enhance traffic operation, and incorporate Intelligent Transportation Systems (ITS).
Location Description: Orange County I-405 PM 0 - 11.4
Contractor Name: Guy F. Atkinson
Contractor Address: 38 Executive Park, IRVINE CA 92614
Resident Engineer: Mona Shahidi Structure Rep.: Brian Vo

Sample Information

DIME Sample ID: 2025-05-30-31
TL Number from the TL Form:
Sample Submitted By Organization: CT D12 - Huntington Beach Field Laboratory
Sample Organization Contact: 9492798846
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 05/30/2025
Date that the sample was received by the laboratory/organization performing the testing: 05/30/2025
The quantity of what the sample constitutes: 3/4 HMA-A
A brief description of the sample: 3/4 HMA-A
From where was the sample collected: Manufacturer
Laboratory sample identification: 25-0549
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA Corona

Material Information

HMA Type: Type A HMA
HMA Grading: 3/4 inch
Lot number:
Sublot number:
HMA Mix Number:
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: 2025-05-30-31-1
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: 06/18/2025
Date Tested: 06/04/2025
Submitted By Organization: CT D12 - Huntington Beach Field Laboratory
Organization Address: 19601 Beach Boulevard,
Organization City: Huntington Beach
Organization State: CA
Organization Zipcode: 92648
Organization Email: frank.mai@dot.ca.gov
Organization Phone: (949) 279-8846
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Number of Samples 1
What is the unit of measurement for theoretical density? US Units
Mass Determination Air
Method Performed Mechanical Agitation - Method A
Mass of container filled with water 1 7309 grams
Mass of oven-dry sample in air for Sample 1 2506.1 grams
Mass of container filled with the sample and water for Sample 1 8832.6 grams
Temperature of Water 77 °F
Specific Gravity for Sample 1 2.551
Theoretical maximum density at 25°C (77°F) 158.8 lb/ft^3

Test 2 of 2

DIME Test ID: 2025-05-30-31-2
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: 07/30/2025
Date Tested: 07/29/2025
Submitted By Organization: CT D12 - Huntington Beach Field Laboratory
Organization Address: 19601 Beach Boulevard,
Organization City: Huntington Beach
Organization State: CA
Organization Zipcode: 92648
Organization Email: frank.mai@dot.ca.gov
Organization Phone: (949) 279-8846
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Bulk Specific Gravity 2.369