Project Information

Project ID: 215236 DEA: 081C6804 EFIS: 0812000343 QA Service Level: 1

DIST-CO-RTE-PM: 08-RIV-74,79and371-Varies

Work Description: REPLACE STRUCTURAL CONCRETE BRIDGE, RETAINING WALL AND BOX CULVERT.

Location Description: RIVERSIDE COUNTY AT VARIOUS LOCATIONS

Contractor Name: Ortiz Enterprise

Contractor Address: 6 Cushing, Suite 200, Irvine, Ca 92618-4221

Resident Engineer: Nick Truong Structure Rep.: Arnel L. Vega

Sample Information

DIME Sample ID: 2022-04-13-21

TL Number from the TL Form:

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

Sample Organization Contact: 9512323690

Type of Sample: Verification

Type of Material: Aggregate

Sample Taken Date: 04/13/2022

Date that the sample was received by the laboratory/organization performing the testing: 04/13/2022

The quantity of what the sample constitutes: 6 Bags Combined Agg., 2 Bags Rap

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

From where was the sample collected: Manufacturer

Laboratory sample identification:

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: California Commercial Asphalt - Lake Elsinore

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-33-0098, 91-33-0011

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 Cut at California Commercial Asphalt Lake Elsinore Plant

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

Primary Aggregate Nominal Size: 3/4 inch

The concrete mix design number:

Lot number:

Sublot number:

Aggregate Mix Number:

Test Results

Test 1 of 2

DIME Test ID: 2022-04-13-21-1

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

Verified Date: 04/15/2022

Date Tested: 04/14/2022

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: 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 %
Cumulative percent passing the 1/2 in. sieve	80 %
Cumulative percent passing the 3/8 in. sieve	69 %
Cumulative percent passing the #4 sieve	48 %
Cumulative percent passing the #8 sieve	36 %
Cumulative percent passing the #16 sieve	25 %
Cumulative percent passing the #30 sieve	17 %
Cumulative percent passing the #50 sieve	12 %
Cumulative percent passing the #100 sieve	8 %
Cumulative percent passing the #200 sieve	6 %

Test 2 of 2

DIME Test ID: 2022-04-13-21-2

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)