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Sample Record for 2020-01-29-17

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

Project Information

Project ID: 213744 DEA: 080P3904 EFIS: 0800001025 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-18-101.5/115.9
Work Description: WIDEN EXISTING SHOULDER TO 8' AND CONSTRUCT SHOULDER RUMBLE STRIPS
Location Description: SAN BERNARDINO COUNTY FROM 0.5 MILE WEST OF ROUTE 395 TO 263 RD STREET.
Contractor Name: C A Rasmussen, Inc.
Contractor Address: 28548 Livingston Ave, Valencia , CA,91355-4171
Resident Engineer: John Santos Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2020-01-29-17
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: Hot Mix Asphalt
Sample Taken Date: 01/29/2020
Date that the sample was received by the laboratory/organization performing the testing: 01/31/2020
The quantity of what the sample constitutes: 2 boxes
A brief description of the sample: 3/4" HMA-A R12
From where was the sample collected: Source
Laboratory sample identification: 0122A-20
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan-San Bernardino Portable

Material Information

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

Test Results

Test 1 of 4

DIME Test ID: 2020-01-29-17-1
Test Method: AASHTO T308-10: Standard Method of Test for Determining the Asphalt Binder Content of Hot Mix Asphalt (HMA) by the Ignition Method (Method A) (Asphalt Binder Content)
Verified Date: 02/06/2020
Date Tested: 02/01/2020
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
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
What temperature unit is used? Fahrenheit
Test procedure used? Method A
Mass of HMA Sample prior to ignition no data
Corrected Asphalt Binder Content 4.33 %
Mass Loss no data
Correction Factor (Percent by mass of HMA Specimen) no data
Moisture Content no data
Temperature Compensation Factor no data
Test Temperature no data

Test 2 of 4

DIME Test ID: 2020-01-29-17-2
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: 02/06/2020
Date Tested: 02/01/2020
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of tests 1
What is the unit of measurement for theoretical density? US Units
Mass Determination Air
Specific Gravity for Sample 1 2.503
Theoretical maximum density at 25°C (77°F) no data

Test 3 of 4

DIME Test ID: 2020-01-29-17-3
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: 02/06/2020
Date Tested: 02/03/2020
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Bulk Specific Gravity 2.392
Bulk Specific Gravity 2 2.392
Bulk Specific Gravity 3 2.395
Average Bulk Specific Gravity 2.393

Test 4 of 4

DIME Test ID: 2020-01-29-17-4
Test Method: AASHTO T269-14: Standard Method of Test for Percent Air Voids in Compacted Dense and Open Asphalt Mixtures (Air Void)
Verified Date: 02/06/2020
Date Tested: 02/03/2020
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
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Percent Air Voids 4.4 %