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Sample Record for 2019-10-05-11

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

Project Information

Project ID: 213746 DEA: 080Q75U4 EFIS: 0817000114 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD,RIV-60-R4.6/R9.9, R0.0/12.2
Work Description: REPLACEMENT OF TWO OUTSIDE LANES AND CONCRETE SLABS
Location Description:
Contractor Name: J McLoughlin Engineering
Contractor Address: 10641 Fulton Court, Rancho Cucamonga, CA 91730
Resident Engineer: Mujahid Qureshi Structure Rep.: Ching Chuang

Sample Information

DIME Sample ID: 2019-10-05-11
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: 9512323690
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/05/2019
Date that the sample was received by the laboratory/organization performing the testing: 10/10/2019
The quantity of what the sample constitutes: 2 boxs, 6 cores
A brief description of the sample: RHMA 3/4" Type G-SP
From where was the sample collected: Manufacturer
Laboratory sample identification: 3A5, 3B5, 3C5, 3A6,3B6,3C6
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Volcan Corona

Material Information

HMA Type: RHMA-G
HMA Grading: 3/4 inch
Lot number: Unknown
Sublot number: Unknown
HMA Mix Number:
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2019-10-05-11-1
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)
Verified Date: 10/29/2019
Date Tested: 10/11/2019
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:
Bulk Specific Gravity 2.237
Bulk Specific Gravity 2 2.241
Bulk Specific Gravity 3 2.266
Average Bulk Specific Gravity 2.248

Test 2 of 3

DIME Test ID: 2019-10-05-11-2
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)
Verified Date: 10/29/2019
Date Tested: 10/11/2019
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:
Bulk Specific Gravity 2.236
Bulk Specific Gravity 2 2.275
Bulk Specific Gravity 3 2.288
Average Bulk Specific Gravity 2.266

Test 3 of 3

DIME Test ID: 2019-10-05-11-3
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Verified Date: 10/29/2019
Date Tested: 10/15/2019
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:
Number of tests 1
What is the unit of measurement for theoretical density? US Units
Mass Determination Water
Specific Gravity for Sample 1 2.413
Theoretical maximum density at 25°C (77°F) no data