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Sample Record for 2023-09-28-22

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: 2023-09-28-22
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: Aggregate
Sample Taken Date: 09/28/2023
Date that the sample was received by the laboratory/organization performing the testing: 09/29/2023
The quantity of what the sample constitutes: 1 Bag CF & 1 Bag RAP
A brief description of the sample: 3/4" CF & RAP
From where was the sample collected: Source
Laboratory sample identification: CFR-39
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Fisher Sand and Gravel

Material Information

Source Identification (SMARA, name of Pit or Job Site): 00 00 0000
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: CF Divertor @ Plant
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:
Sublot number:
Aggregate Mix Number:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2023-09-28-22-1
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)
Verified Date: 10/02/2023
Date Tested: 10/02/2023
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: CF-R39
Test Result Compliance: complies
Additional Comments When Verified:
Sand Equivalent 79

Test 2 of 2

DIME Test ID: 2023-09-28-22-2
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 10/02/2023
Date Tested: 10/02/2023
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: CF-R39
Test Result Compliance: complies
Additional Comments When Verified:
What type of gradation is being tested? Combined Gradation
Cumulative percent passing the 2 in. sieve 100 %
Cumulative percent passing the 1 1/2 in. sieve 100 %
Cumulative percent passing the 1 in. sieve 100 %
Cumulative percent passing the 3/4 in. sieve 92 %
Cumulative percent passing the 1/2 in. sieve 75 %
Cumulative percent passing the 3/8 in. sieve 68 %
Cumulative percent passing the #4 sieve 41 %
Cumulative percent passing the #8 sieve 26 %
Cumulative percent passing the #16 sieve 19 %
Cumulative percent passing the #30 sieve 13 %
Cumulative percent passing the #50 sieve 8 %
Cumulative percent passing the #100 sieve 5 %
Cumulative percent passing the #200 sieve 3.2 %