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Sample Record for 2024-03-19-57

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

Project Information

Project ID: 994785 DEA: 023H32U4 EFIS: 0221000164 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-I5-2.5/R15.9
Work Description: Roadway rehabilitation and bridge improvements along I5 in Mount Shasta
Location Description: SIS I5 2.5/R15.9
Contractor Name: Gordon Stout - Walsh/Myers
Contractor Address: 1390 Willow Pass Rd Suite 950, Concord, CA 94520
Resident Engineer: Austin Henry Structure Rep.: Mike Sears

Sample Information

DIME Sample ID: 2024-03-19-57
TL Number from the TL Form: 866068
Sample Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Sample Organization Contact: (530) 225-3194
Type of Sample: Production Start-Up
Type of Material: Aggregate
Sample Taken Date: 03/19/2024
Date that the sample was received by the laboratory/organization performing the testing: 03/19/2024
The quantity of what the sample constitutes: JMF Verification / Production Start-Up Evaluation
A brief description of the sample: 2 bags of Combined Lime Treated 3/4-inch Aggregate
From where was the sample collected: Manufacturer
Laboratory sample identification: D79451A
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Tullis — Northstate Asphalt (Redding, CA)

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-45-0057::Shasta Ranch Aggregates (Anderson, CA)
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: Cold Feed
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): 1

Test Results

Test 1 of 1

DIME Test ID: 2024-03-19-57-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 05/09/2024
Date Tested: 03/22/2024
Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Organization Address: 1657 Riverside Drive,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: 530-225-3194
General Comments for this Test: P1=100.%, P¾=100.%, P½=91%, P№4=36%, P№8=23%, P№30=11%, P№200=4.7%
Test Result Compliance: not applicable
Additional Comments When Verified:
What type of gradation is being tested? HMA Gradation
Cumulative percent passing the 2 in. sieve no data
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 100 %
Cumulative percent passing the 1/2 in. sieve 91 %
Cumulative percent passing the 3/8 in. sieve 67 %
Cumulative percent passing the #4 sieve 36 %
Cumulative percent passing the #8 sieve 23 %
Cumulative percent passing the #16 sieve 15 %
Cumulative percent passing the #30 sieve 11 %
Cumulative percent passing the #50 sieve 8 %
Cumulative percent passing the #100 sieve 6 %
Cumulative percent passing the #200 sieve 4.7 %