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Sample Record for 2025-12-17-14

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: 2025-12-17-14
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: 12/17/2025
Date that the sample was received by the laboratory/organization performing the testing: 12/17/2025
The quantity of what the sample constitutes: 3/4 RHMAG
A brief description of the sample: 3/4 RHMAG
From where was the sample collected: Manufacturer
Laboratory sample identification: 25-1173
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA Corona

Material Information

HMA Type: RHMA-G
HMA Grading: 3/4 inch
Lot number:
Sublot number:
HMA Mix Number:
Binder content (%): 0.0
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: 2025-12-17-14-1
Test Method: AASHTO T308-10: Standard Method of Test for Determining the Asphalt Binder Content of Hot Mix Asphalt (HMA) by the Ignition Method (Method A) (Asphalt Binder Content)
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
Data has not been verified.

Test 2 of 2

DIME Test ID: 2025-12-17-14-2
Test Method: AASHTO T209-25: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
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
Data has not been verified.