Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994599 DEA: 081N1604 EFIS: 0822000106
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-40-R20.0/R28.1
Work Description: RHMA, HIGH DENSITY POLYURETHANE INJECTION, AND COLD PLANE AC PVMT.
Location Description: SAN BERNARDINO COUNTY NEAR BARSTOW FROM 0.3 MILE WEST OF NEWBERRY ROAD OVERCROSSING TO DESERT OASIS REST AREA
Contractor Name: SULLY-MILLER CONTRACTING COMPANY
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2023-09-20-76
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Barstow Field Laboratory 1
Sample Organization Contact: (760) 252-9216
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 09/20/2023
Date that the sample was received by the laboratory/organization performing the testing: 09/28/2023
The quantity of what the sample constitutes: 1
A brief description of the sample: cores
From where was the sample collected: Job Site
Laboratory sample identification: L1 SL1 1C
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sully Miller
DIME Test ID: 2023-09-20-76-1
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: 10/09/2023
Date Tested: 10/03/2023
Submitted By Organization: CT D08 - Barstow Field Laboratory 1
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test: REL COMPACT 95.7%
Test Result Compliance:
Additional Comments When Verified:
|
Bulk Specific Gravity
|
2.353
|
