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Sample Record for 2020-01-22-27

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: 2020-01-22-27
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: 01/22/2020
Date that the sample was received by the laboratory/organization performing the testing: 02/10/2020
The quantity of what the sample constitutes: 2 boxs, 8 cores
A brief description of the sample: 3/4" HMA PG64-28M
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Matich Plant Rialto

Material Information

HMA Type: Type A HMA
HMA Grading: 3/4 inch
Lot number: Unknown
Sublot number: Unknown
HMA Mix Number:

Test Results

Test 1 of 4

DIME Test ID: 2020-01-22-27-1
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: 02/20/2020
Date Tested: 02/12/2020
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria St.,
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 2.286
Bulk Specific Gravity 2 2.320
Bulk Specific Gravity 3 2.327
Average Bulk Specific Gravity 2.311

Test 2 of 4

DIME Test ID: 2020-01-22-27-2
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: 02/20/2020
Date Tested: 02/12/2020
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria St.,
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 2.342
Bulk Specific Gravity 2 2.323
Bulk Specific Gravity 3 2.325
Average Bulk Specific Gravity 2.33

Test 3 of 4

DIME Test ID: 2020-01-22-27-3
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: 02/20/2020
Date Tested: 02/12/2020
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria St.,
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 2.338
Bulk Specific Gravity 2 2.321
Average Bulk Specific Gravity 2.33

Test 4 of 4

DIME Test ID: 2020-01-22-27-4
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: 02/20/2020
Date Tested: 02/13/2020
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria St.,
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
Mass Determination Water
Specific Gravity for Sample 1 2.515
Theoretical maximum density at 25°C (77°F) no data