Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 9999 DEA: 00000000 EFIS: 0000000000 COOP: 99999333399 MINOR: 333333 Permit Numbers: 555555 0400NRT0000
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: YYZ
Contractor Address: 1234 address, Sacramento, CA 95824
Resident Engineer: RE_first RE_last Structure Rep.: SR_First SR_Last
DIME Sample ID: 2020-03-10-11
TL Number from the TL Form:
Sample Submitted By Organization: ZZCT - Sacramento DIME Development - AVS Testing Internal
Sample Organization Contact:
Type of Sample: Verification
Type of Material: Hot Mix Asphalt
Sample Taken Date: 03/10/2020
Date that the sample was received by the laboratory/organization performing the testing: 03/10/2020
The quantity of what the sample constitutes: HMA
A brief description of the sample: HMA
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Mark West Quarry
DIME Test ID: 2020-03-10-11-1
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: 03/10/2020
Date Tested: 03/10/2020
Submitted By Organization: ZZCT - Sacramento DIME Development - AVS Testing Internal
Organization Address: 123 Street,
Organization City: Sacramento
Organization State: CA
Organization Zipcode:
Organization Email:
Organization Phone:
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
What temperature unit is used?
|
Fahrenheit
|
Test procedure used?
|
Method A
|
Mass of HMA Sample prior to ignition
|
2345.0 g
|
Corrected Asphalt Binder Content
|
4.87 %
|
Mass Loss
|
no data
|
Correction Factor (Percent by mass of HMA Specimen)
|
0.42 %
|
Moisture Content
|
0.04 %
|
Temperature Compensation Factor
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no data
|
Test Temperature
|
10000 F
|