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Sample Record for 2023-07-17-41

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 215349 DEA: 081C0824 EFIS: 0816000087 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-10-R104.9/R134.2
Work Description: PLACE HMA (TYPE A), JPCP AND IMPORTED BORROW.
Location Description: RIVERSIDE COUNTY FROM ROUTE 10/177 SEPARATION TO 1.1 MILES WEST OF WILEY'S WELL RD OC
Contractor Name: FISHER SAND & GRAVEL CO.
Contractor Address: 1302 W DRIVERS WAY, TEMPE, AZ. 85284
Resident Engineer: Khoi Vu Structure Rep.: Shukri Abouazra

Sample Information

DIME Sample ID: 2023-07-17-41
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Blythe Field Testing Laboratory
Sample Organization Contact: 9096015132
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 07/17/2023
Date that the sample was received by the laboratory/organization performing the testing: 07/28/2023
The quantity of what the sample constitutes: 1 box, 3 cores
A brief description of the sample: 3/4" PG 58-34 #CA125MA
From where was the sample collected: Manufacturer
Laboratory sample identification: 1A, 1B, 1C
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Fisher Sand and Gravel

Material Information

HMA Type: Type A HMA
HMA Grading: 3/4 inch
Lot number:
Sublot number:
HMA Mix Number:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2023-07-17-41-1
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Verified Date: 10/26/2023
Date Tested: 07/29/2023
Submitted By Organization: CT D08 - Blythe Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: brian.teh@dot.ca.gov
Organization Phone: (909) 601-5132
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of tests 1
What is the unit of measurement for theoretical density? US Units
Mass Determination Air
Specific Gravity for Sample 1 2.418
Theoretical maximum density at 25°C (77°F) 150.9 lb/ft^3

Test 2 of 2

DIME Test ID: 2023-07-17-41-2
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: 10/26/2023
Date Tested: 07/29/2023
Submitted By Organization: CT D08 - Blythe Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: brian.teh@dot.ca.gov
Organization Phone: (909) 601-5132
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Bulk Specific Gravity 2.337
Bulk Specific Gravity 2 2.311
Bulk Specific Gravity 3 2.31
Average Bulk Specific Gravity 2.319