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Sample Record for 2019-06-27-7

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: 2019-06-27-7
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: 9512323690
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 06/27/2019
Date that the sample was received by the laboratory/organization performing the testing: 06/29/2019
The quantity of what the sample constitutes: PSE 11 bags
A brief description of the sample: 3/4 HMA-A-SP R12
From where was the sample collected: Manufacturer
Laboratory sample identification: 0365A-19
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Matich-Lytle Creek

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-36-0040::LYTLE CREEK
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: LHP-62D
The plant number: Unknown
A detailed description of where the material sample was collected: Belt Cut at Plant
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: Unknown
Sublot number: Unknown
Aggregate Mix Number:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2019-06-27-7-1
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: 07/08/2019
Date Tested: 07/01/2019
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Sand Equivalent 66

Test 2 of 2

DIME Test ID: 2019-06-27-7-2
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 07/08/2019
Date Tested: 07/01/2019
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
What type of gradation is being tested? Combined Gradation
Cumulative percent passing the 2 in. sieve 100 %
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 84 %
Cumulative percent passing the 3/8 in. sieve 73 %
Cumulative percent passing the #4 sieve 44 %
Cumulative percent passing the #8 sieve 33 %
Cumulative percent passing the #16 sieve 25 %
Cumulative percent passing the #30 sieve 18 %
Cumulative percent passing the #50 sieve 11 %
Cumulative percent passing the #100 sieve 7 %
Cumulative percent passing the #200 sieve 4.7 %