Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212112 DEA: 080C2514 EFIS: 0816000076 COOP: 081645
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-10-0.0/13.2
Work Description: Design-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location Description: LA/SBD County Line to PM 13.2 near I-15
Contractor Name: Lane-Security Paving Joint Venture
Contractor Address: 3450 Centre Lake Drive, 1st Floor, Ontario, CA 91761
Resident Engineer: Jose Corona Structure Rep.: Luis Negrete
DIME Sample ID: 2022-07-06-54
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: 07/06/2022
Date that the sample was received by the laboratory/organization performing the testing: 08/02/2022
The quantity of what the sample constitutes: 2 Boxes HMA 179.31 tons out
A brief description of the sample: 3//4" HMA-A-SP R15 0.5% LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0518A-22
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Corona
DIME Test ID: 2022-07-06-54-1
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: 08/08/2022
Date Tested: 08/03/2022
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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4.73 %
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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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