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Sample Record for 2023-09-21-30

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

Project Information

Project ID: 214135 DEA: 09213404 EFIS: 0900000030 QA Service Level: 1
DIST-CO-RTE-PM: 09-INY-395-29.9/41.8
Work Description: ROADWAY EXCAVATION, PLACE HMA (TYPE A), AND ALTERNATIVE PIPE CULVERT.
Location Description: INYO COUNTY NEAR OLANCHA AND CARTAGO FROM 1.4 MILES SOUTH OF LOS ANGELES AQUEDUCT BRIDGE TO 0.2 MILE SOUTH OF ASH CREEK BRIDGE
Contractor Name: FISHER SAND & GRAVEL CO.
Contractor Address: 1302 W DRIVERS WAY, TEPE, AZ. 85284
Resident Engineer: Kris Raber Structure Rep.: Sheila Reyes

Sample Information

DIME Sample ID: 2023-09-21-30
TL Number from the TL Form:
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Department Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 09/21/2023
Date that the sample was received by the laboratory/organization performing the testing: 09/22/2023
The quantity of what the sample constitutes: 1 Box of HMA Cores
A brief description of the sample: 3/4" HMA Cores
From where was the sample collected: Job Site
Laboratory sample identification: Core-R18
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: 2023-09-21-30-1
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: 09/25/2023
Date Tested: 09/22/2023
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
General Comments for this Test: Core-R18
Test Result Compliance: complies
Additional Comments When Verified:
Bulk Specific Gravity 2.359
Bulk Specific Gravity 2 2.305
Bulk Specific Gravity 3 2.33
Average Bulk Specific Gravity 2.331

Test 2 of 2

DIME Test ID: 2023-09-21-30-2
Test Method: AASHTO T269-14: Standard Method of Test for Percent Air Voids in Compacted Dense and Open Asphalt Mixtures (Air Void)
Verified Date: 09/25/2023
Date Tested: 09/25/2023
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
General Comments for this Test: Core-R18
Test Result Compliance: complies
Additional Comments When Verified:
Percent Air Voids 6.1 %
Percent Air Voids 2 8.2 %
Percent Air Voids 3 7.2 %
Average Percent Air Voids 7.2 %