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Sample Record for 2018-06-19-15

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

Project Information

Project ID: 212845 DEA: 023H1304 QA Service Level: 1
DIST-CO-RTE-PM: 02-LAS-395-47.0/56.5
Work Description: AC OVERLAY, REPLACE AC SURFACE, RUMBLE STRIP, GUARDRAIL
Location Description: LASSEN COUNTY AT AND NEAR JANESVILLE FROM 1.9 MILES SOUTH OF LAKECREST DRIVE TO 0.2 MILE NORTH OF SUNNYSIDE ROAD
Contractor Name: HAT CREEK CONSTRUCTION & MATERIALS, INC.
Contractor Address: Unknown
Resident Engineer: JOHN YOLTON Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2018-06-19-15
TL Number from the TL Form: T101 C990857
Sample Submitted By Organization: CT D02 - North Region Materials Lab
Sample Organization Contact: (530) 225-3194
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 06/19/2018
Date that the sample was received by the laboratory/organization performing the testing: 06/25/2018
The quantity of what the sample constitutes: 3 boxs
A brief description of the sample: 3/4 HMA A, 15 rap, PG64-28m
From where was the sample collected: Manufacturer
Laboratory sample identification: D77477
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Ward Lake Hat Crk Construction

Material Information

HMA Type: Type A HMA
HMA Grading: 3/4 inch
Lot number:
Sublot number:

Test Results

Test 1 of 3

DIME Test ID: 2018-06-19-15-1
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Drive, MS-83,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
Data has not been verified.

Test 2 of 3

DIME Test ID: 2018-06-19-15-2
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)
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Drive, MS-83,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
Data has not been verified.

Test 3 of 3

DIME Test ID: 2018-06-19-15-3
Test Method: AASHTO T269-14: Standard Method of Test for Percent Air Voids in Compacted Dense and Open Asphalt Mixtures (Air Void)
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Drive, MS-83,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
Data has not been verified.

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.