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: 2021-04-22-21
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Barstow Field Laboratory 1
Sample Organization Contact: (760) 252-9216
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 04/22/2021
Date that the sample was received by the laboratory/organization performing the testing: 05/04/2021
The quantity of what the sample constitutes: 2
A brief description of the sample: 3/4" core
From where was the sample collected: Job Site
Laboratory sample identification: 124A ,124B,
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sully Miller
DIME Test ID: 2021-04-22-21-1
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: 05/10/2021
Date Tested: 05/05/2021
Submitted By Organization: CT D08 - Barstow Field Laboratory 1
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Bulk Specific Gravity
|
2.306
|
Bulk Specific Gravity 2
|
2.311
|
Average Bulk Specific Gravity
|
2.309
|