Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994966 DEA: 073255U4 EFIS: 0722000129
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-605-20.2/26
Work Description: INDIVIDUAL SLAB REPLACEMENT, COLD PLANE AC
Location Description: LOS ANGELES COUNTY IN BALDWIN PARK AND IRWINDALE FROM ROUTE 10/605 SEPARATION TO 0.2 MILE NORTH OF ROUTE 210/605 SEPARATION
Contractor Name: Peterson Chase General Engineering
Contractor Address: 16351 Construction Circle West, Irvine, CA 92606
Resident Engineer: Steven Taing Structure Rep.: Unknown
DIME Sample ID: 2025-07-08-1
TL Number from the TL Form: 061925
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: 07/08/2025
Date that the sample was received by the laboratory/organization performing the testing: 07/08/2025
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4" RHMA-G
From where was the sample collected: Manufacturer
Laboratory sample identification: 25-367
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA Irwindale
DIME Test ID: 2025-07-08-1-1
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: 07/08/2025
Date Tested: 07/08/2025
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:
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Number of Samples
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1
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What is the unit of measurement for theoretical density?
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US Units
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Mass Determination
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Air
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Method Performed
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Mechanical Agitation - Method A
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Mass of container filled with water 1
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7353.3 grams
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Mass of oven-dry sample in air for Sample 1
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2552.8 grams
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Mass of container filled with the sample and water for Sample 1
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8858.7 grams
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Temperature of Water
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77 °F
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Specific Gravity for Sample 1
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2.437
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Theoretical maximum density at 25°C (77°F)
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151.7 lb/ft^3
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