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Sample Record for 2021-01-12-20

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: 2021-01-12-20
TL Number from the TL Form:
Sample Submitted By Organization: CT D01 - Field Laboratory
Sample Organization Contact: (707) 445-6373
Type of Sample: Verification
Type of Material: Hot Mix Asphalt
Sample Taken Date: 01/12/2021
Date that the sample was received by the laboratory/organization performing the testing: 01/25/2021
The quantity of what the sample constitutes: JMF Prequalification
A brief description of the sample: 16 Boxes HMA
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Syar Todd Road Batch

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: 2021-01-12-20-1
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: 02/02/2021
Date Tested: 02/02/2021
Submitted By Organization: CT D01 - Field Laboratory
Organization Address: 1726 Albee St,
Organization City: Eureka
Organization State: CA
Organization Zipcode: 95501
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 445-6373
General Comments for this Test:
Additional Comments When Verified:
Number of tests 1
Mass Determination Air
Method Performed no data
Mass of container filled with water 7382.4 grams
Mass of oven-dry sample in air for Sample 1 1703.5 grams
Mass of container filled with the sample and water for Sample 1 8396.1 grams
Temperature of Water 77 °F
Specific Gravity for Sample 1 2.470

Test 2 of 3

DIME Test ID: 2021-01-12-20-2
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: 02/02/2021
Date Tested: 02/02/2021
Submitted By Organization: CT D01 - Field Laboratory
Organization Address: 1726 Albee St,
Organization City: Eureka
Organization State: CA
Organization Zipcode: 95501
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 445-6373
General Comments for this Test:
Additional Comments When Verified:
Bulk Specific Gravity 2.454
Bulk Specific Gravity 2 2.454
Bulk Specific Gravity 3 2.459
Average Bulk Specific Gravity 2.456

Test 3 of 3

DIME Test ID: 2021-01-12-20-3
Test Method: AASHTO T269-14: Standard Method of Test for Percent Air Voids in Compacted Dense and Open Asphalt Mixtures (Air Void)
Verified Date: 02/02/2021
Date Tested: 02/02/2021
Submitted By Organization: CT D01 - Field Laboratory
Organization Address: 1726 Albee St,
Organization City: Eureka
Organization State: CA
Organization Zipcode: 95501
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 445-6373
General Comments for this Test:
Additional Comments When Verified:
Percent Air Voids 0.6 %
Percent Air Voids 2 0.6
Percent Air Voids 3 0.4
Percent Air Voids Average 0.5

Tests Assigned to this Sample

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