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Sample Record for 2018-05-04-15

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

Project Information

Project ID: 212950 DEA: 044H2104 EFIS: 0413000140 QA Service Level: 1
DIST-CO-RTE-PM: 04-SM-1-37.9/R48.0
Work Description: ASPHALT CONCRETE SURFACING, GRIND PCC PAVEMENT.
Location Description: SAN MATEO COUNTY NEAR MONTARA, IN PACIFICA AND DALY CITY FROM 1.3 MILES NORTH OF 2ND STREET TO ROUTE 280
Contractor Name: GRANITE ROCK COMPANY
Contractor Address: 5225 Hellyer Ave, Suite 220, San Jose, CA 95138
Resident Engineer: Marcus Washington Structure Rep.: Peter Lam

Sample Information

DIME Sample ID: 2018-05-04-15
TL Number from the TL Form: C236007
Sample Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Sample Organization Contact: (916) 227-7204
Type of Sample: Dispute Resolution
Type of Material: Aggregate
Sample Taken Date: 05/04/2018
Date that the sample was received by the laboratory/organization performing the testing: 08/02/2018
The quantity of what the sample constitutes: 2 bags combine grade
A brief description of the sample: combine 3/4 coarse and fine
From where was the sample collected: Other
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: na

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-35-0012 and 91-01-0011
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: Bell Cat
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:
Aggregate Mix Number:
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2018-05-04-15-1
Test Method: AASHTO T85-13: Standard Method of Test for Specific Gravity and Absorption of Coarse Aggregate (Coarse Specific Gravity)
Verified Date: 08/08/2018
Date Tested: 08/08/2018
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bang.d.nguyen@dot.ca.gov
Organization Phone: (916) 227-7204
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Basis for relative density testing Bulk
Specific Gravity 2.667
Absorption 1.5 %

Test 2 of 3

DIME Test ID: 2018-05-04-15-2
Test Method: AASHTO T85-13: Standard Method of Test for Specific Gravity and Absorption of Coarse Aggregate (Coarse Specific Gravity)
Verified Date: 08/08/2018
Date Tested: 08/08/2018
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bang.d.nguyen@dot.ca.gov
Organization Phone: (916) 227-7204
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Basis for relative density testing Apparent
Specific Gravity 2.78
Absorption 1.5 %

Test 3 of 3

DIME Test ID: 2018-05-04-15-3
Test Method: AASHTO T85-13: Standard Method of Test for Specific Gravity and Absorption of Coarse Aggregate (Coarse Specific Gravity)
Verified Date: 08/09/2018
Date Tested: 08/08/2018
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bang.d.nguyen@dot.ca.gov
Organization Phone: (916) 227-7204
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Basis for relative density testing Bulk SSD
Specific Gravity 2.708
Absorption 1.5 %