Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214438 DEA: 080G6914 EFIS: 0815000184
QA Service Level: 1
DIST-CO-RTE-PM: 08---
Work Description: RELINE OR REPLACE CULVERTS
Location Description: SAN BERNARDINO COUNTY IN AND NEAR SAN BERNARDINO FROM 48TH STREET TO ROUTE 18/138 SEPARATION
Contractor Name: SUKUT CONSTRUCTION, LLC.
Contractor Address: Unknown
Resident Engineer: NHAN NGUYEN Structure Rep.: Unknown
DIME Sample ID: 2022-12-07-30
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: 12/07/2022
Date that the sample was received by the laboratory/organization performing the testing: 12/16/2022
The quantity of what the sample constitutes: 8 Boxes
A brief description of the sample: 3/4" MHA-A-SP R12 0.75% LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0779A-22
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Matich-Lytle Creek
DIME Test ID: 2022-12-07-30-1
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: 12/21/2022
Date Tested: 12/19/2022
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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4.82 %
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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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