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Sample Record for 2021-06-03-26

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

Project Information

Project ID: 215424 DEA: 024G4404 EFIS: 0214000013 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-3-38.0/38.6
Work Description: BRIDGE REPLACEMENT
Location Description: SISKIYOU COUNTY ABOUT 6 MILES NORTH OF FORT JONES FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF LOWER MOFFETT CREEK ROAD
Contractor Name: Steelhead Constructors
Contractor Address: 2940 INNSBRUCK DRIVE, REDDING CA 96003
Resident Engineer: Nicole Mallory Structure Rep.: O'Sullivan, Andy

Sample Information

DIME Sample ID: 2021-06-03-26
TL Number from the TL Form: 779365
Sample Submitted By Organization: CT D02 - North Region Materials Lab
Sample Organization Contact: (530) 225-3194
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 06/03/2021
Date that the sample was received by the laboratory/organization performing the testing: 06/03/2021
The quantity of what the sample constitutes: 395 Tons
A brief description of the sample: PSE 3/4 HMA 22 RAP PG 58-34M Valero Benecia
From where was the sample collected: Manufacturer
Laboratory sample identification: D78822
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Tullis Inc, Northstate Asphalt, Redding CA

Material Information

HMA Type: Type A HMA
HMA Grading: 3/4 inch
Lot number: Unknown
Sublot number: Unknown

Test Results

Test 1 of 4

DIME Test ID: 2021-06-03-26-1
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Dr,MS-83
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
Data has not been verified.

Test 2 of 4

DIME Test ID: 2021-06-03-26-2
Test Method: AASHTO T308-10: Standard Method of Test for Determining the Asphalt Binder Content of Hot Mix Asphalt (HMA) by the Ignition Method (Asphalt Binder Content)
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Dr,MS-83
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
Data has not been verified.

Test 3 of 4

DIME Test ID: 2021-06-03-26-3
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)
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Dr,MS-83
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
Data has not been verified.

Test 4 of 4

DIME Test ID: 2021-06-03-26-4
Test Method: AASHTO T283-14: Standard Method of Test for Resistance of Compacted Asphalt Mixtures to Moisture-Induced Damage (Moisture Content)
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Dr,MS-83
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
Data has not been verified.

Tests Assigned to this Sample

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