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Sample Record for 2017-11-01-7

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

Project Information

Project ID: 9999 DEA: 00000000 EFIS: 0000000000 COOP: 99999333399 MINOR: 333333 Permit Numbers: 555555 0400NRT0000 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: YYZ
Contractor Address: 1234 address, Sacramento, CA 95824
Resident Engineer: RE_first RE_last Structure Rep.: SR_Last, SR_First

Sample Information

DIME Sample ID: 2017-11-01-7
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Sample Organization Contact: 7146885366
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 11/01/2017
Date that the sample was received by the laboratory/organization performing the testing: 11/01/2017
The quantity of what the sample constitutes: 1
A brief description of the sample: for JMF verification
From where was the sample collected: Manufacturer
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Mustang

Material Information

Source Identification (SMARA or name of Pit): 123456
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: testing for JMF Verification
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: Unknown
Lot number:
Sublot number:

Test Results

Test 1 of 10

DIME Test ID: 2017-11-01-7-4
Test Method: AASHTO T96-02r10: Standard Method of Test for Resistance to Degradation of Small-Size Coarse Aggregate by Abrasion and Impact in the Los Angeles Machine (Los Angeles Rattler)
Verified Date: 11/01/2017
Date Tested: 11/01/2017
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
General Comments for this Test:
Additional Comments When Verified:
Grading designation A
Percent loss after 100 revolutions 3 %
Percent loss after 500 revolutions 15 %

Test 2 of 10

DIME Test ID: 2017-11-01-7-5
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: 11/01/2017
Date Tested: 11/01/2017
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
General Comments for this Test:
Additional Comments When Verified:
Sand Equivalent 80

Test 3 of 10

DIME Test ID: 2017-11-01-7-6
Test Method: AASHTO T304-11: Standard Method of Test for Uncompacted Void Content of Fine Aggregate (Fine of Crushed Particles)
Verified Date: 11/01/2017
Date Tested: 11/02/2017
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
General Comments for this Test:
Additional Comments When Verified:
What test method is performed? Method A
Bulk dry specific gravity 2.661
Average uncompacted voids 46.1 %

Test 4 of 10

DIME Test ID: 2017-11-01-7-7
Test Method: ASTM D4791-10: Standard Test Method for Flat Particles, Elongated Particles, or Flat and Elongated Particles in Coarse Aggregate (Withdrawn 2019) (Flat and Elongated Particles)
Verified Date: 11/01/2017
Date Tested: 11/01/2017
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
General Comments for this Test:
Additional Comments When Verified:
Method A
Determination By Number
Dimensional ratio used 1:2
Weighted percentage of particles (by number) that were flat 0 %
Weighted percentage of particles (by number) that were elongated 0 %
Weighted percentage of particles (by number) that were both flat and elongated 0 %
Weighted percentage of particles (by number) that were neither flat nor elongated 0 %

Test 5 of 10

DIME Test ID: 2017-11-01-7-8
Test Method: AASHTO T85-13: Standard Method of Test for Specific Gravity and Absorption of Coarse Aggregate (Coarse Specific Gravity)
Verified Date: 11/01/2017
Date Tested: 11/01/2017
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
General Comments for this Test:
Additional Comments When Verified:
Basis for relative density testing Bulk
Specific Gravity 2.661
Absorption 2 %

Test 6 of 10

DIME Test ID: 2017-11-01-7-9
Test Method: AASHTO T84-14: Standard Method of Test for Specific Gravity and Absorption of Fine Aggregate (Fine Specific Gravity)
Verified Date: 11/01/2017
Date Tested: 11/01/2017
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
General Comments for this Test:
Additional Comments When Verified:
Bulk specific gravity 2.653
Bulk specific gravity (SSD Basis) 2.708
Apparent specific gravity 2.808
Absorption 2.1 %

Test 7 of 10

DIME Test ID: 2017-11-01-7-10
Test Method: AASHTO T335-09r13: Standard Method of Test for Determining the Percentage of Fracture in Coarse Aggregate (Percent of Crushed Particles)
Verified Date: 11/01/2017
Date Tested: 11/01/2017
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
General Comments for this Test:
Additional Comments When Verified:
Method 1 - Combined Fracture Determination
Aggregate Size and Fracture Type Coarse 1 and 2 Faced and Fine 1 Faced
Percentage of fractured, coarse, 2 faced particles tested 100 %
Percentage of fractured, coarse, 1 faced particles tested 100 %
Percentage of fractured, fine, 1 faced particles tested 99 %

Test 8 of 10

DIME Test ID: 2017-11-01-7-11
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 11/07/2017
Date Tested: 11/07/2017
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
General Comments for this Test:
Additional Comments When Verified:
What type of gradation is being tested? HMA Gradation
Does this test use 1/4 sieve? (question for HMA Gradation Type) Yes
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 94.5 %
Cumulative percent passing the 1/2 in. sieve 71.3 %
Cumulative percent passing the 3/8 in. sieve 69.5 %
Cumulative percent passing the 1/4 in. sieve 69.5 %
Cumulative percent passing the #4 sieve 44.3 %
Cumulative percent passing the #8 sieve 30.3 %
Cumulative percent passing the #16 sieve 21.6 %
Cumulative percent passing the #30 sieve 14.6 %
Cumulative percent passing the #50 sieve 10 %
Cumulative percent passing the #100 sieve 6 %
Cumulative percent passing the #200 sieve 4.03 %

Test 9 of 10

DIME Test ID: 2017-11-01-7-12
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: 10/19/2018
Date Tested: 10/04/2018
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
General Comments for this Test:
Additional Comments When Verified:
Sand Equivalent 90

Test 10 of 10

DIME Test ID: 2017-11-01-7-13
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 12/06/2019
Date Tested: 12/06/2019
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
General Comments for this Test:
Additional Comments When Verified:
What type of gradation is being tested? HMA Gradation
Does this test use 1/4 sieve? (question for HMA Gradation Type) Yes
Cumulative percent passing the 1 1/2 in. sieve 100 %
Cumulative percent passing the 1 in. sieve 99 %
Cumulative percent passing the 3/4 in. sieve 99.6 %
Cumulative percent passing the 1/2 in. sieve 71.6 %
Cumulative percent passing the 3/8 in. sieve 68.5 %
Cumulative percent passing the 1/4 in. sieve 68.3 %
Cumulative percent passing the #4 sieve 42.3 %
Cumulative percent passing the #8 sieve 30.2 %
Cumulative percent passing the #16 sieve 22.2 %
Cumulative percent passing the #30 sieve 14.9 %
Cumulative percent passing the #50 sieve 9.6 %
Cumulative percent passing the #100 sieve 5 %
Cumulative percent passing the #200 sieve 4.65 %

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
2017-11-01-7-14AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)02/03/2021Not scheduledDavid PhongCT HQ - Sacramento Office of Structural Materials Field Laboratory