Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993222 DEA: 081G5204 EFIS: 0816000020
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-18-100.9/115.9
Work Description: COLD PLANE AC PAVEMENT & PLACE HMA AND MINOR CONCRETE.
Location Description: SAN BERNARDINO COUNTY IN AND NEAR ADELANTO FROM LOS ANGELES COUNTY LINE TO ROUTE 395
Contractor Name: SULLY - MILLER CONTRACTING COMPANY
Contractor Address: 135 S STATE COLLEGE BLVD. 400, BREA, CA 92821
Resident Engineer: Mauricio Santa Cruz Structure Rep.: Unknown
DIME Sample ID: 2022-06-02-12
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Department Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 06/02/2022
Date that the sample was received by the laboratory/organization performing the testing: 06/08/2022
The quantity of what the sample constitutes: 4 Boxes HMA 194.54 tons out
A brief description of the sample: 1/2" HMA-A R25 0.6% Evotherm
From where was the sample collected: Manufacturer
Laboratory sample identification: 0346A-22
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Diamond Victorville
DIME Test ID: 2022-06-02-12-1
Test Method: AASHTO T308-10: Standard Method of Test for Determining the Asphalt Binder Content of Hot Mix Asphalt (HMA) by the Ignition Method (Method A) (Asphalt Binder Content)
Verified Date: 06/13/2022
Date Tested: 06/09/2022
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: (909) 829-3029
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
What temperature unit is used?
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Fahrenheit
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Test procedure used?
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no data
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Mass of HMA Sample prior to ignition
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no data
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Corrected Asphalt Binder Content
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5.21 %
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Mass Loss
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no data
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Correction Factor (Percent by mass of HMA Specimen)
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no data
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Moisture Content
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no data
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Temperature Compensation Factor
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no data
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Test Temperature
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no data
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