Sample Record for 2022-03-11-21
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 211848 DEA: 112T2174 EFIS: 1116000131
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-5-R37.4 - R46.5
Work Description: (Alternative Delivery) CMGC, San Elijo Highway Bridge Replacement. Replace the San Elijo lagoon highway bridge, construct HOV lanes, construct bike and pedestrian trails and bridge, build multi-use facility at Manchester Ave.
Location Description: IN SAN DIEGO COUNTY IN SOLANA BEACH AND ENCINITAS FROM 0.1 MILE NORTH OF LOMAS SANTA FE DRIVE OVERCROSSING TO 0.2 MILE SOUTH OF BIRMINGHAM DRIVE OVERCROSSING
Contractor Name: Flatiron-Skanska-Stacy and Witbeck, a Joint Venture
Contractor Address: 1770 La Costa Meadows Drive, San Marcos, CA 92078
Resident Engineer: Steve McMillan Structure Rep.: Phong Le
Sample Information
DIME Sample ID: 2022-03-11-21
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: Aggregate
Sample Taken Date: 03/11/2022
Date that the sample was received by the laboratory/organization performing the testing: 03/11/2022
The quantity of what the sample constitutes: 4 bags, 12 boxes, 3 cans
A brief description of the sample: 1/2" HMA-A
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CCA Lakeside
Material Information
Source Identification (SMARA, name of Pit or Job Site): CCA Lakeside
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: Stock Pile
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
Test 1 of 1
DIME Test ID: 2022-03-11-21-4
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: 08/29/2024
Date Tested: 03/16/2022
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:
Test Result Compliance: complies
Additional Comments When Verified:
