Project Information

Project ID: 213707 DEA: 081C38U4 EFIS: 0817000196 QA Service Level: 1

DIST-CO-RTE-PM: 08-RIV-10-6.7/R25.1

Work Description: Remove concrete pavement and base, and place HMA and JPCP

Location Description: ROUTE 10/60 SEPARATION IN BEAUMONT TO ROUTE 10/111 SEPARATION NEAR CABAZON.

Contractor Name: Coffman Specialties

Contractor Address: 9685 Via Excelencia, San Diego, CA 92126

Resident Engineer: Elvira Lenart Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-01-13-12

TL Number from the TL Form:

Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory

Sample Organization Contact: 9512323690

Type of Sample: Quality Assurance

Type of Material: Aggregate

Sample Taken Date: 01/13/2021

Date that the sample was received by the laboratory/organization performing the testing: 01/14/2021

The quantity of what the sample constitutes: 4 Bags

A brief description of the sample: HMA-A 3/4" R24

From where was the sample collected: Manufacturer

Laboratory sample identification: 1

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: California Commercial Asphalt - Coachella

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-33-0084

The fabricator's/manufacturer's product name for the sample:

The fabricator/manufacturer designation for the sample:

The plant number:

A detailed description of where the material sample was collected: belt an chute

Where the material sample would have been placed if not sampled:

Primary Aggregate Nominal Size: 3/4 inch

The concrete mix design number: 43417615

Lot number:

Sublot number:

Aggregate Mix Number:

Test Results

Test 1 of 2

DIME Test ID: 2021-01-13-12-1

Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)

Verified Date: 01/15/2021

Date Tested: 01/14/2021

Submitted By Organization: CT D08 - Fontana Field Testing Laboratory

Organization Address: 13970 Victoria Street,

Organization City: Fontana

Organization State: CA

Organization Zipcode: 92336

Organization Email: prakash.gowda@dot.ca.gov

Organization Phone: (951) 232-3690

General Comments for this Test:

Test Result Compliance:

Additional Comments When Verified:

What type of gradation is being tested?	Combined Gradation
Cumulative percent passing the 2 in. sieve	100 %
Cumulative percent passing the 1 1/2 in. sieve	100 %
Cumulative percent passing the 1 in. sieve	100 %
Cumulative percent passing the 3/4 in. sieve	98 %
Cumulative percent passing the 1/2 in. sieve	83 %
Cumulative percent passing the 3/8 in. sieve	71 %
Cumulative percent passing the #4 sieve	44 %
Cumulative percent passing the #8 sieve	34 %
Cumulative percent passing the #16 sieve	25 %
Cumulative percent passing the #30 sieve	18 %
Cumulative percent passing the #50 sieve	12 %
Cumulative percent passing the #100 sieve	7 %
Cumulative percent passing the #200 sieve	4.2 %

Test 2 of 2

DIME Test ID: 2021-01-13-12-2

Test Method: AASHTO T176-08: Standard Method of Test for Plastic Fines in Graded Aggregates and Soils by Use of the Sand Equivalent Test (Sand Equivalent)