Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 66667 DEA: JMFPP EFIS: 0019000043
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for JMF Prequalification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2026-01-08-12
TL Number from the TL Form:
Sample Submitted By Organization: CT D11 - District 11 Materials Laboratory
Sample Organization Contact: (858) 518-8709
Type of Sample: Verification
Type of Material: Hot Mix Asphalt
Sample Taken Date: 01/08/2026
Date that the sample was received by the laboratory/organization performing the testing: 01/08/2026
The quantity of what the sample constitutes: 12 boxes
A brief description of the sample: JMFR
From where was the sample collected: Supplier
Laboratory sample identification: 25-09-22-40-JMFR
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: API Gateway
HMA Type: Type A HMA
HMA Grading: 1/2 inch
Lot number:
Sublot number:
HMA Mix Number: 39 API Val
Binder content (%): 4.5
Virgin binder PG: PG 70-10
Design binder PG: PG 70-10
Binder Supplier: Valero
RAP content (%): 0
WMA Additives: No
Antistrip type: Lime
DIME Test ID: 2026-01-08-12-2
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Submitted By Organization: CT D11 - District 11 Materials Laboratory
Organization Address: 4050 Taylor Street,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92110
Organization Email: benjamin.haney@dot.ca.gov
Organization Phone: (858) 688-1595
Data has not been verified.
DIME Test ID: 2026-01-08-12-3
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)
Submitted By Organization: CT D11 - District 11 Materials Laboratory
Organization Address: 4050 Taylor Street,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92110
Organization Email: benjamin.haney@dot.ca.gov
Organization Phone: (858) 688-1595
Data has not been verified.
DIME Test ID: 2026-01-08-12-4
Test Method: AASHTO T269-14: Standard Method of Test for Percent Air Voids in Compacted Dense and Open Asphalt Mixtures (Air Void)
Submitted By Organization: CT D11 - District 11 Materials Laboratory
Organization Address: 4050 Taylor Street,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92110
Organization Email: benjamin.haney@dot.ca.gov
Organization Phone: (858) 688-1595
Data has not been verified.
