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Sample Record for 2020-10-15-3

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

Project Information

Project ID: 66667 DEA: JMFPP EFIS: 0019000043 QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for JMF Prequalification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2020-10-15-3
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - DME / District Lab
Sample Organization Contact: (510) 507-3456
Type of Sample: Verification
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/15/2020
Date that the sample was received by the laboratory/organization performing the testing: 10/15/2020
The quantity of what the sample constitutes: 22 Box
A brief description of the sample: 22 Box of HMA
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Syar Industries

Material Information

HMA Type: Type A HMA
HMA Grading: 1/2 inch
Lot number:
Sublot number:

Test Results

Test 1 of 3

DIME Test ID: 2020-10-15-3-1
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: 10/16/2020
Date Tested: 09/19/2020
Submitted By Organization: CT D04 - DME / District Lab
Organization Address: 21339 Cabot Blvd,
Organization City: Hayward
Organization State: CA
Organization Zipcode: 94545
Organization Email: mohammad.dehghan@dot.ca.gov
Organization Phone: (510) 507-3456
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Bulk Specific Gravity 2.419
Bulk Specific Gravity 2 2.429
Bulk Specific Gravity 3 2.427
Average Bulk Specific Gravity 2.425

Test 2 of 3

DIME Test ID: 2020-10-15-3-2
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: 10/16/2020
Date Tested: 10/15/2020
Submitted By Organization: CT D04 - DME / District Lab
Organization Address: 21339 Cabot Blvd,
Organization City: Hayward
Organization State: CA
Organization Zipcode: 94545
Organization Email: mohammad.dehghan@dot.ca.gov
Organization Phone: (510) 507-3456
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Number of tests 1
Mass Determination Air
Specific Gravity for Sample 1 2.465

Test 3 of 3

DIME Test ID: 2020-10-15-3-3
Test Method: AASHTO T269-14: Standard Method of Test for Percent Air Voids in Compacted Dense and Open Asphalt Mixtures (Air Void)
Verified Date: 10/16/2020
Date Tested: 09/15/2020
Submitted By Organization: CT D04 - DME / District Lab
Organization Address: 21339 Cabot Blvd,
Organization City: Hayward
Organization State: CA
Organization Zipcode: 94545
Organization Email: mohammad.dehghan@dot.ca.gov
Organization Phone: (510) 507-3456
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Percent Air Voids 1.9 %
Percent Air Voids 2 1.5 %
Percent Air Voids 3 1.5 %
Percent Air Voids Average 1.6 %

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.