Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214819 DEA: 07288304 EFIS: 0700021024
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-60,60,164,210-Var
Work Description: STORM WATER MITIGATION
Location Description: LOS ANGELES COUNTY AT VARIOUS LOCATIONS
Contractor Name: CHUMO CONSTRUCTION INC
Contractor Address: 14425 Joanbridge St, Baldwin Park, CA 91706
Resident Engineer: Sushilkumar Chaudhari Structure Rep.: Pratheep Piratheepan
DIME Sample ID: 2022-05-16-33
TL Number from the TL Form: na
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Department Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 05/16/2022
Date that the sample was received by the laboratory/organization performing the testing: 05/19/2022
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4" hma - a220831 sva sjr
From where was the sample collected: Job Site
Laboratory sample identification: 22-0130
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA Corona
DIME Test ID: 2022-05-16-33-1
Test Method: AASHTO T275-07r12: Standard Method of Test for Bulk Specific Gravity (Gmb) of Compacted Asphalt Mixtures Using Paraffin-Coated Specimens (Bulk Specific Gravity)
Verified Date: 05/23/2022
Date Tested: 05/20/2022
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 817-0387
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
|
Bulk Specific Gravity
|
2.391
|
