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Sample Record for 2019-11-23-22

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

Project Information

Project ID: 214157 DEA: 081H3404 EFIS: 0817000016 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-210,215-21.1/R26.3,4.1/14.3
Work Description: PRECAST SLAB AND CURB RAMP REPLACEMENT AND PLACE RHMA-G.
Location Description: SAN BERNARDINO COUNTY ON ROUTE 210 FROM 0.6 MILE EAST OF STATE STREET TO STERLING AVENUE AND ON ROUTE 215 FROM PALM STREET TO ROUTE 10/215 SEPARATION
Contractor Name: RV CONCRETE, INC.
Contractor Address: 605 E COMMERCIAL ST, ANAHEIM CA 92801
Resident Engineer: Samer Georges Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-11-23-22
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: (951) 840-8328
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 11/23/2019
Date that the sample was received by the laboratory/organization performing the testing: 12/11/2019
The quantity of what the sample constitutes: 2 box, 6 Core
A brief description of the sample: 3/4" RHMA-SP PG64-16RB
From where was the sample collected: Manufacturer
Laboratory sample identification: 1A, 2A, 3A, 4A, 5A, 6A
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA-Corona

Material Information

HMA Type: RHMA-G
HMA Grading: 3/4 inch
Lot number: Unknown
Sublot number: Unknown
HMA Mix Number:

Test Results

Test 1 of 3

DIME Test ID: 2019-11-23-22-1
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: 12/19/2019
Date Tested: 12/03/2019
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: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Bulk Specific Gravity 2.244
Bulk Specific Gravity 2 2.278
Bulk Specific Gravity 3 2.277
Average Bulk Specific Gravity 2.266

Test 2 of 3

DIME Test ID: 2019-11-23-22-2
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: 12/19/2019
Date Tested: 12/03/2019
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: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Bulk Specific Gravity 2.262
Bulk Specific Gravity 2 2.234
Bulk Specific Gravity 3 2.234
Average Bulk Specific Gravity 2.243

Test 3 of 3

DIME Test ID: 2019-11-23-22-3
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: 12/19/2019
Date Tested: 12/16/2019
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: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
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 2.449
Theoretical maximum density at 25°C (77°F) no data