Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214451 DEA: 07303704 EFIS: 0714000035
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-101-8.0/27.3
Work Description: REPLACE CONCRETE BARRIERS.
Location Description: THE CITY AND COUNTY OF LOS ANGELES FROM PILGRIMAGE OVERCROSSING TO VALLEY CIRCLE BOULEVARD OVERCROSSING
Contractor Name: OHL USA
Contractor Address: 1920 Main Street, Suite 310, Irvine, California 92614
Resident Engineer: Kevin Bui Structure Rep.: Kwangsuk Suh
DIME Sample ID: 2023-04-18-68
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: 04/18/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/21/2023
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: 23-078
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA Irwindale
DIME Test ID: 2023-04-18-68-1
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: 04/26/2023
Date Tested: 04/24/2023
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) 407-6963
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
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Bulk Specific Gravity
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2.398
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