Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214885 DEA: 080K1234 EFIS: 0815000242
QA Service Level: 1
DIST-CO-RTE-PM: 08---
Work Description:
Location Description:
Contractor Name: SULLY-MILLER CONTRACTING COMPANY
Contractor Address: 135 S STATE COLLEGE BLVD #400, BREA CA 92821
Resident Engineer: Taghreed Al-Khateeb Structure Rep.: Unknown
DIME Sample ID: 2020-10-01-6
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: Department Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/01/2020
Date that the sample was received by the laboratory/organization performing the testing: 10/02/2020
The quantity of what the sample constitutes: 2 boxes 102 tons out
A brief description of the sample: 3/4" HMA-A R15 PG 64-28M (1.0% LSM)
From where was the sample collected: Manufacturer
Laboratory sample identification: 0572-20
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Diamond Oro Grande, Cemex White Mountain
DIME Test ID: 2020-10-01-6-1
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: 10/07/2020
Date Tested: 10/06/2020
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: (909) 829-3029
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
What temperature unit is used?
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Fahrenheit
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Test procedure used?
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Method A
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Mass of HMA Sample prior to ignition
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no data
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Corrected Asphalt Binder Content
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4.64 %
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Mass Loss
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no data
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Correction Factor (Percent by mass of HMA Specimen)
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no data
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Moisture Content
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no data
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Temperature Compensation Factor
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no data
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Test Temperature
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no data
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