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Sample Record for 2020-07-27-3

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

Project Information

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

Sample Information

DIME Sample ID: 2020-07-27-3
TL Number from the TL Form: 200120
Sample Submitted By Organization: CT D04 - Hayward DME / District Laboratory
Sample Organization Contact: (510) 507-3456
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 07/27/2020
Date that the sample was received by the laboratory/organization performing the testing: 07/27/2020
The quantity of what the sample constitutes: n bags
A brief description of the sample: test
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: ve

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-37-0039
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: tttt
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1-1/2 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2020-07-27-3-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Submitted By Organization: CT D04 - Hayward DME / District Laboratory
Organization Address: 111 Grand Avenue,
Organization City: Oakland
Organization State: CA
Organization Zipcode: 94623
Organization Email: mohammad.dehghan@dot.ca.gov
Organization Phone: (510) 286-4717
Data has not been verified.

Test 2 of 2

DIME Test ID: 2020-07-27-3-3
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 07/28/2020
Date Tested: 07/21/2020
Submitted By Organization: CT D04 - Hayward DME / District Laboratory
Organization Address: 111 Grand Avenue,
Organization City: Oakland
Organization State: CA
Organization Zipcode: 94623
Organization Email: mohammad.dehghan@dot.ca.gov
Organization Phone: (510) 286-4717
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified: babak.kamranimoghaddam@dot.ca.gov
What type of gradation is being tested? HMA Gradation
Cumulative percent passing the 1 1/2 in. sieve 100 %
Cumulative percent passing the 1 in. sieve 100 %
Cumulative percent passing the 3/4 in. sieve 95 %
Cumulative percent passing the 1/2 in. sieve 68 %
Cumulative percent passing the 3/8 in. sieve 55 %
Cumulative percent passing the #4 sieve 52 %
Cumulative percent passing the #8 sieve 49 %
Cumulative percent passing the #16 sieve 47 %
Cumulative percent passing the #30 sieve 36 %
Cumulative percent passing the #50 sieve 19 %
Cumulative percent passing the #100 sieve 12 %
Cumulative percent passing the #200 sieve 2 %

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
2020-07-27-3-2AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)07/27/202007/27/2020Babak KamranimoghaddamCT D04 - Hayward DME / District Laboratory