Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994620 DEA: 120T6304 EFIS: 1222000073
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-39-3.2/5.8
Work Description: COLD PLANE AC PVMT AND PLACE RHMA.
Location Description: ORANGE COUNTY IN HUNTINGTON BEACH FROM ELLIS AVENUE/MAIN STREET TO STARK DRIVE
Contractor Name: R.J. NOBLE COMPANY
Contractor Address: 15505 E. Lincoln Ave, Orange, CA 92865
Resident Engineer: Steven Kim Structure Rep.: Unknown
DIME Sample ID: 2023-10-27-78
TL Number from the TL Form:
Sample Submitted By Organization: CT D12 - Huntington Beach Field Laboratory
Sample Organization Contact: 9492798846
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/27/2023
Date that the sample was received by the laboratory/organization performing the testing: 10/30/2023
The quantity of what the sample constitutes: HMA cores
A brief description of the sample: 1/2 RWMA-SP
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RJ Noble Orange
DIME Test ID: 2023-10-27-78-1
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: 01/03/2024
Date Tested: 11/24/2023
Submitted By Organization: CT D12 - Huntington Beach Field Laboratory
Organization Address: 19601 Beach Boulevard,
Organization City: Huntington Beach
Organization State: CA
Organization Zipcode: 92648
Organization Email: frank.mai@dot.ca.gov
Organization Phone: (949) 279-8846
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
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Bulk Specific Gravity
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2.298
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