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Sample Record for 2020-12-15-18

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

Project Information

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

Sample Information

DIME Sample ID: 2020-12-15-18
TL Number from the TL Form:
Sample Submitted By Organization: CT D05 - San Luis Obispo District Laboratory
Sample Organization Contact: (559) 230-3109
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 12/15/2020
Date that the sample was received by the laboratory/organization performing the testing: 01/06/2021
The quantity of what the sample constitutes: One JMFPP Verification
A brief description of the sample: Bags of Aggregate
From where was the sample collected: Manufacturer
Laboratory sample identification: D5 21-J-001
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Syar Todd Batch

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-49-0004::CANYON ROCK CO., INC.
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: At the Plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test results on following page(s): 7

Test Results

Test 1 of 7

DIME Test ID: 2020-12-15-18-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 01/22/2021
Date Tested: 01/11/2021
Submitted By Organization: CT D05 - San Luis Obispo District Laboratory
Organization Address: 50 Higuera Street,
Organization City: San Luis Obispo
Organization State: CA
Organization Zipcode: 93401
Organization Email: glenn.johnson@dot.ca.gov
Organization Phone: (805) 549-3158
General Comments for this Test:
Test Result Compliance: complies
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 97.3 %
Cumulative percent passing the 1/2 in. sieve 80.9 %
Cumulative percent passing the 3/8 in. sieve 66.7 %
Cumulative percent passing the #4 sieve 46.7 %
Cumulative percent passing the #8 sieve 33.4 %
Cumulative percent passing the #16 sieve 23 %
Cumulative percent passing the #30 sieve 16.1 %
Cumulative percent passing the #50 sieve 11.3 %
Cumulative percent passing the #100 sieve 7.4 %
Cumulative percent passing the #200 sieve 4.6 %

Test 2 of 7

DIME Test ID: 2020-12-15-18-2
Test Method: AASHTO T335-09r13: Standard Method of Test for Determining the Percentage of Fracture in Coarse Aggregate (Percent of Crushed Particles)
Verified Date: 01/22/2021
Date Tested: 01/12/2021
Submitted By Organization: CT D05 - San Luis Obispo District Laboratory
Organization Address: 50 Higuera Street,
Organization City: San Luis Obispo
Organization State: CA
Organization Zipcode: 93401
Organization Email: glenn.johnson@dot.ca.gov
Organization Phone: (805) 549-3158
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Method 2 - Individual Fracture Determination
Aggregate Size and Fracture Type Coarse 1 and 2 Faced and Fine 1 Faced
Weighted average percentage of fractured, coarse, 2 faced particles 98 %
Weighted average percentage of fractured, coarse, 1 faced particles 99 %
Percentage of fractured, fine, 1 faced particles tested 97 %

Test 3 of 7

DIME Test ID: 2020-12-15-18-3
Test Method: AASHTO T96-02r10: Standard Method of Test for Resistance to Degradation of Small-Size Coarse Aggregate by Abrasion and Impact in the Los Angeles Machine (Los Angeles Rattler)
Verified Date: 01/22/2021
Date Tested: 01/15/2021
Submitted By Organization: CT D05 - San Luis Obispo District Laboratory
Organization Address: 50 Higuera Street,
Organization City: San Luis Obispo
Organization State: CA
Organization Zipcode: 93401
Organization Email: glenn.johnson@dot.ca.gov
Organization Phone: (805) 549-3158
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Grading designation B
Mass of sample on No.12 sieve (after 500 revolutions) 4159 grams
Percent loss after 100 revolutions 5 %
Percent loss after 500 revolutions 17 %

Test 4 of 7

DIME Test ID: 2020-12-15-18-4
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)
Verified Date: 01/22/2021
Date Tested: 01/12/2021
Submitted By Organization: CT D05 - San Luis Obispo District Laboratory
Organization Address: 50 Higuera Street,
Organization City: San Luis Obispo
Organization State: CA
Organization Zipcode: 93401
Organization Email: glenn.johnson@dot.ca.gov
Organization Phone: (805) 549-3158
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Sand Equivalent 63

Test 5 of 7

DIME Test ID: 2020-12-15-18-5
Test Method: ASTM D4791-10: Standard Test Method for Flat Particles, Elongated Particles, or Flat and Elongated Particles in Coarse Aggregate (Withdrawn 2019) (Flat and Elongated Particles)
Verified Date: 01/22/2021
Date Tested: 01/15/2021
Submitted By Organization: CT D05 - San Luis Obispo District Laboratory
Organization Address: 50 Higuera Street,
Organization City: San Luis Obispo
Organization State: CA
Organization Zipcode: 93401
Organization Email: glenn.johnson@dot.ca.gov
Organization Phone: (805) 549-3158
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Method B
Determination By Mass
Dimensional ratio used 5:1
Weighted percentage of particles (by mass) that were flat and elongated 0 %
Weighted percentage of particles (by mass) that were not flat and elongated 100 %

Test 6 of 7

DIME Test ID: 2020-12-15-18-6
Test Method: AASHTO T85-13: Standard Method of Test for Specific Gravity and Absorption of Coarse Aggregate (Coarse Specific Gravity)
Verified Date: 01/22/2021
Date Tested: 01/13/2021
Submitted By Organization: CT D05 - San Luis Obispo District Laboratory
Organization Address: 50 Higuera Street,
Organization City: San Luis Obispo
Organization State: CA
Organization Zipcode: 93401
Organization Email: glenn.johnson@dot.ca.gov
Organization Phone: (805) 549-3158
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
Basis for relative density testing Bulk
Specific Gravity 2.662
Absorption 0.8 %

Test 7 of 7

DIME Test ID: 2020-12-15-18-7
Test Method: AASHTO T84-14: Standard Method of Test for Specific Gravity and Absorption of Fine Aggregate (Fine Specific Gravity)
Verified Date: 01/22/2021
Date Tested: 01/14/2021
Submitted By Organization: CT D05 - San Luis Obispo District Laboratory
Organization Address: 50 Higuera Street,
Organization City: San Luis Obispo
Organization State: CA
Organization Zipcode: 93401
Organization Email: glenn.johnson@dot.ca.gov
Organization Phone: (805) 549-3158
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
Bulk specific gravity 2.575
Bulk specific gravity (SSD Basis) 2.626
Apparent specific gravity 2.714
Absorption 2 %