Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214698 DEA: 120N8904 EFIS: 1214000130
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-133-8.3/M9.3
Work Description: CONSTRUCT AUXILIARY LANE.
Location Description: ORANGE COUNTY IN IRVINE FROM ROUTE 133/405 SEPARATION TO IRVINE CENTER DRIVE OVERCROSSING
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3200 Park Center Drive, Suite #200, Costa Mesa, CA 92626
Resident Engineer: Arezo Ghiam Structure Rep.: Michael Yee
DIME Sample ID: 2025-06-21-8
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: 06/21/2025
Date that the sample was received by the laboratory/organization performing the testing: 07/29/2025
The quantity of what the sample constitutes: 3/4 WMA-SP
A brief description of the sample: 3/4 WMA-SP
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Corona
DIME Test ID: 2025-06-21-8-1
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: 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:
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Bulk Specific Gravity
|
2.365
|
