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Sample Record for 2019-02-25-10

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

Project Information

Project ID: 213551 DEA: 080K2934 EFIS: 0812000100 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-10-R36.8/R39.2
Work Description: PAVEMENT REHABILITATION AND CONTINUOUSLY REINFORCED CONCRETE PAVEMENT
Location Description: SAN BERNARDINO COUNTY IN YUCAIPA FROM 0.2 MILE WEST OF LIVE OAK CANYON ROAD TO COUNTY LINE ROAD UNDERCROSSING
Contractor Name: Coffman Specialties
Contractor Address: 9685 Via Excelencia, San Diego, CA 92126
Resident Engineer: Ezz Gayed Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-02-25-10
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: Acceptance
Type of Material: Asphalt Binder
Sample Taken Date: 02/25/2019
Date that the sample was received by the laboratory/organization performing the testing: 02/28/2019
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: Matich PLant Lytle creek
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Matich Plant

Material Information

Performance Grade: PG 64-28 M
Modified: Yes
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier:
Multigrade:
Multigrade Type:
Asphalt Binder Mix Number:

Test Results

Test 1 of 6

DIME Test ID: 2019-02-25-10-1
Test Method: AASHTO T240-17: Standard Method of Test for Effect of Heat and Air on a Moving Film of Asphalt Binder (Rolling Thin-Film Oven Test)
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: 9098293029
Data has not been verified.

Test 2 of 6

DIME Test ID: 2019-02-25-10-2
Test Method: AASHTO T228-09r13: Standard Method of Test for Specific Gravity of Semi-Solid Asphalt Materials (Specific Gravity)
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: 9098293029
Data has not been verified.

Test 3 of 6

DIME Test ID: 2019-02-25-10-3
Test Method: AASHTO T315-12: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
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: 9098293029
Data has not been verified.

Test 4 of 6

DIME Test ID: 2019-02-25-10-4
Test Method: AASHTO T315-12: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
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: 9098293029
Data has not been verified.

Test 5 of 6

DIME Test ID: 2019-02-25-10-5
Test Method: AASHTO T44-14: Standard Method of Test for Solubility of Bituminous Materials
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: 9098293029
Data has not been verified.

Test 6 of 6

DIME Test ID: 2019-02-25-10-6
Test Method: AASHTO T316-17: Standard Method of Test for Viscosity Determination of Asphalt Binder Using Rotational Viscometer
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: 9098293029
Data has not been verified.