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Sample Record for 2025-12-21-7

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

Project Information

Project ID: 995468 DEA: 114B0084 EFIS: 1122000208 QA Service Level: 1
DIST-CO-RTE-PM: 11---
Work Description:
Location Description:
Contractor Name: Rubbia Khan Griffith COmpany
Contractor Address: 3050 East Birch Street, Brea, CA, 92821
Resident Engineer: Alfredo Hernandez Medina Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2025-12-21-7
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: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 12/21/2025
Date that the sample was received by the laboratory/organization performing the testing: 12/22/2025
The quantity of what the sample constitutes: 4 boxes
A brief description of the sample: JMFR
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: MM Lakeside

Material Information

HMA Type: Type A HMA
HMA Grading: 1/2 inch
Lot number:
Sublot number:
HMA Mix Number: 2121705
Binder content (%): 0.0
Virgin binder PG:
Design binder PG:
Binder Supplier: Valero
RAP content (%): 0
WMA Additives: No
Antistrip type:
Test results on following page(s): 2

Test Results

Test

DIME Test ID: 2025-12-21-7-1
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)
Verified Date: 04/27/2026
Date Tested: 04/27/2026
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
General Comments for this Test: Target: 5.25% Actual: 6.01% Oven#3
Test Result Compliance: does not comply
Additional Comments When Verified:
What temperature unit is used? Fahrenheit
Test procedure used? Method A
Mass of the specimen basket assembly 4024.3 g
Mass of the specimen and specimen basket assembly prior to ignition 5548.6 g
Mass of HMA Sample prior to ignition 1524.3 g
Corrected Asphalt Binder Content 6.01 %
Mass Loss 92.3 g
Mass of aggregate remaining after ignition 1432 g
Correction Factor (Percent by mass of HMA Specimen) 0.05 %
Moisture Content no data0 %
Temperature Compensation Factor no data0 %
Test Temperature 1000 F

Test

DIME Test ID: 2025-12-21-7-2
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.