Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994397 DEA: 073393U4 EFIS: 0722000031
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-605-R11.4/R19.5
Work Description: CONSTRUCT DPPIA DEVICES AND MODIFY LIGHTING SYSTEMS.
Location Description: LOS ANGELES COUNTY AT VARIOUS LOCATIONS FROM 0.1 MILE SOUTH OF SLAUSON AVENUE UNDERCROSSING TO 0.5 MILE NORTH OF VALLEY BOULEVARD UNDERCROSSING
Contractor Name: Chumo Construction
Contractor Address: 14425 Joanbridge St, Baldwin Park, CA 91706
Resident Engineer: Peter Lee Structure Rep.: Unknown
DIME Sample ID: 2024-03-11-25
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Production Start-Up
Type of Material: Aggregate
Sample Taken Date: 03/11/2024
Date that the sample was received by the laboratory/organization performing the testing: 03/18/2024
The quantity of what the sample constitutes: 2 Bags of Combined Agg., 1 Bag Rap
A brief description of the sample: PSUE 3/4" HMA-A-SP R15
From where was the sample collected: Manufacturer
Laboratory sample identification: 0138A-24
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: All American Asphalt- Corona
Source Identification (SMARA, name of Pit or Job Site): 91-33-0005
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: Belt Cut at All American Corona Plant
Where the material sample would have been placed if not sampled: Asphalt Paving
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: 105793
Lot number:
Sublot number:
Aggregate Mix Number:
DIME Test ID: 2024-03-11-25-11
Test Method: AASHTO T209-22: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Verified Date: 05/17/2024
Date Tested: 03/19/2024
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: (909) 829-3029
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
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Number of Samples
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2
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What is the unit of measurement for theoretical density?
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SI Units
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Mass Determination
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Air
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Method Performed
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Mechanical Agitation - Method A
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Mass of container filled with water 1
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7352.8 grams
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Mass of oven-dry sample in air for Sample 1
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2562.4 grams
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Mass of container filled with the sample and water for Sample 1
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8906.4 grams
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Mass of container filled with water 2
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7329 grams
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Mass of oven-dry sample in air for Sample 2
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2556.2 grams
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Mass of container filled with the sample and water for Sample 2
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8882.4 grams
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Temperature of Water
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25 °F
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Specific Gravity for Sample 1
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2.54
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Specific Gravity for Sample 2
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2.549
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Average Specific Gravity
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2.545
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Theoretical maximum density at 25°C (77°F)
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2538 kg/m^3
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