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Sample Record for 2019-04-28-3

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

Project Information

Project ID: 213912 DEA: 033H71U4 EFIS: 0319000051 QA Service Level: 1
DIST-CO-RTE-PM: 03-BUT-70-8.8/12.1
Work Description: WIDEN RDWY, RDWY EX, HMA & MODIFY ELECT SYSTEM.
Location Description: BUTTE COUNTY NEAR OROVILLE FROM 0.1 MILE SOUTH OF PALERMO ROAD TO 0.6 MILE NORTH OF OPHIR ROAD
Contractor Name: A. TEICHERT & SON, INC. DBA TEICHERT CONSTRUCTION
Contractor Address: 400 Sunrise Ave. Ste. 300, Roseville, CA 95661
Resident Engineer: Ryan Johnson Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-04-28-3
TL Number from the TL Form:
Sample Submitted By Organization: Teichert Materials - Sacramento
Sample Organization Contact: (916) 386-6974
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 04/28/2019
Date that the sample was received by the laboratory/organization performing the testing: 04/19/2019
The quantity of what the sample constitutes: 1 production lot
A brief description of the sample: JMF mix design data
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Materials Hallwood

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-58-0006::HALLWOOD PLANT
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: Stockpile @ Plant
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number: Unknown
Lot number: Unknown
Sublot number: Unknown
Aggregate Mix Number:
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2019-04-28-3-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Submitted By Organization: Teichert Materials - Sacramento
Organization Address: 3500 American River Drive,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95864
Organization Email: egifford@teichert.com
Organization Phone: (916) 386-6974
Data has not been verified.

Test 2 of 3

DIME Test ID: 2019-04-28-3-2
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: 05/29/2019
Date Tested: 04/19/2019
Submitted By Organization: Teichert Materials - Sacramento
Organization Address: 3500 American River Drive,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95864
Organization Email: egifford@teichert.com
Organization Phone: (916) 386-6974
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Method B
Determination By Number
Dimensional ratio used 1:5
Weighted percentage of particles (by number) that were flat and elongated 1 %
Weighted percentage of particles (by number) that were not flat and elongated 99 %

Test 3 of 3

DIME Test ID: 2019-04-28-3-3
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 05/31/2019
Date Tested: 04/19/2019
Submitted By Organization: Teichert Materials - Sacramento
Organization Address: 3500 American River Drive,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95864
Organization Email: egifford@teichert.com
Organization Phone: (916) 386-6974
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
What type of gradation is being tested? HMA Gradation
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 57 %
Cumulative percent passing the 3/8 in. sieve 16 %
Cumulative percent passing the 1/4 in. sieve 0 %
Cumulative percent passing the #4 sieve 1 %
Cumulative percent passing the #8 sieve 1 %
Cumulative percent passing the #16 sieve 0 %
Cumulative percent passing the #30 sieve 0 %
Cumulative percent passing the #50 sieve 0 %
Cumulative percent passing the #100 sieve 0 %
Cumulative percent passing the #200 sieve 0 %