Project Information

Project ID: 214573 DEA: 073096U4 EFIS: 0719000091 QA Service Level: 1

DIST-CO-RTE-PM: 07-LA-210-R0.0/R9.7

Work Description: PLACE CONCRETE PAVEMENT, BARRIER, HMA, DRAINAGE, AND ELECTRICAL.

Location Description: LOS ANGELES COUNTY IN LOS ANGELES FROM INTERSTATE 5 TO WHEATLAND AVENUE UNDERCROSSING

Contractor Name: FLATIRON WEST INC

Contractor Address: 15335 FAIRFIELD RANCH ROAD, CHINO HILLS, CA 91709

Resident Engineer: Ridwan Salman Structure Rep.: Adriana Pimienta

Sample Information

DIME Sample ID: 2022-06-07-16

TL Number from the TL Form:

Sample Submitted By Organization: CT D07 - Plant Services

Sample Organization Contact: 562-345-3126

Type of Sample: Department Acceptance

Type of Material: Aggregate

Sample Taken Date: 06/07/2022

Date that the sample was received by the laboratory/organization performing the testing: 06/08/2022

The quantity of what the sample constitutes: 5 Bags of bin Agg, 1 Bag of RAP

A brief description of the sample: 3/4" HMA-A-SP R15 0.5% LAS

From where was the sample collected: Source

Laboratory sample identification:

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: Sheldon/Boulevard/Big Rock Creek

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-19-0017/91-19-0019/91-19-0021

The fabricator's/manufacturer's product name for the sample:

The fabricator/manufacturer designation for the sample:

The plant number: 220831 SVA LTR

A detailed description of where the material sample was collected: Conveyor Belt

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

Test 1 of 2

DIME Test ID: 2022-06-07-16-1

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

Verified Date: 06/10/2022

Date Tested: 06/08/2022

Submitted By Organization: CT D07 - Plant Services

Organization Address: 13230 East Firestone Boulevard, Suite G,

Organization City: Santa Fe Springs

Organization State: CA

Organization Zipcode: 90670

Organization Email: victor.zengler@dot.ca.gov

Organization Phone: (562) 345-3126

General Comments for this Test:

Test Result Compliance:

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	98 %
Cumulative percent passing the 1/2 in. sieve	84 %
Cumulative percent passing the 3/8 in. sieve	71 %
Cumulative percent passing the #4 sieve	49 %
Cumulative percent passing the #8 sieve	33 %
Cumulative percent passing the #16 sieve	23 %
Cumulative percent passing the #30 sieve	16 %
Cumulative percent passing the #50 sieve	10 %
Cumulative percent passing the #100 sieve	6 %
Cumulative percent passing the #200 sieve	3.2 %

Test 2 of 2

DIME Test ID: 2022-06-07-16-2

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)