Sample Record for 2023-04-19-92
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214986 DEA: 041J9704 EFIS: 0414000404
QA Service Level: 1
DIST-CO-RTE-PM: 04-SCL-17-2.8/13.94
Work Description: PAVING WITH RHMA, COLD PLANE AC, AND INSTALL CULVERT.
Location Description: SANTA CLARA COUNTY IN AND NEAR LOS GATOS, CAMPBELL AND SAN JOSE FROM HEBARD ROAD TO ROUTE 17/280 SEPARATION
Contractor Name: GRANITE ROCK COMPANY
Contractor Address: 120 Granite Rock, San Jose, CA 95136
Resident Engineer: Ali Nikzad Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2023-04-19-92
TL Number from the TL Form: C927716
Sample Submitted By Organization: CT D04 - San Jose Construction Field Laboratory
Sample Organization Contact: (510) 385-8171
Type of Sample: Production Start-Up
Type of Material: Aggregate
Sample Taken Date: 04/19/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/19/2023
The quantity of what the sample constitutes: 24 Boxes HMA, 4 Qts Binder, 5 bags BIN 1, 5 BAGS BIN 2, 5 BAGS BIN 3, 4 BAGS BIN 4
A brief description of the sample: MIX: 917 3/4" RHMA-G SP
From where was the sample collected: Manufacturer
Laboratory sample identification: SJ-041823-PSU
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite rock Aromas Batch plant
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-35-0012
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Material pulled from bin 1, 2, 3 AND 4
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: 1
Sublot number: 102
Aggregate Mix Number: 917
Test Results
Test 1 of 3
DIME Test ID: 2023-04-19-92-1
Test Method: AASHTO T11-5: Standard Method of Test for Materials Finer Than 75-μm (No. 200) Sieve in Mineral Aggregates by Washing
Submitted By Organization: CT D04 - San Jose Construction Field Laboratory
Organization Address: 1007 Knox Avenue,
Organization City: San Jose
Organization State: CA
Organization Zipcode: 95122
Organization Email: fernando.vega@dot.ca.gov
Organization Phone: (510) 385-8171
Data has not been verified.
Test 2 of 3
DIME Test ID: 2023-04-19-92-2
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Submitted By Organization: CT D04 - San Jose Construction Field Laboratory
Organization Address: 1007 Knox Avenue,
Organization City: San Jose
Organization State: CA
Organization Zipcode: 95122
Organization Email: fernando.vega@dot.ca.gov
Organization Phone: (510) 385-8171
Data has not been verified.
Test 3 of 3
DIME Test ID: 2023-04-19-92-3
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)
Submitted By Organization: CT D04 - San Jose Construction Field Laboratory
Organization Address: 1007 Knox Avenue,
Organization City: San Jose
Organization State: CA
Organization Zipcode: 95122
Organization Email: fernando.vega@dot.ca.gov
Organization Phone: (510) 385-8171
Data has not been verified.
