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Sample Record for 2021-06-17-41

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

Project Information

Project ID: 212777 DEA: 021H1104 EFIS: 0215000106 QA Service Level: 1
DIST-CO-RTE-PM: 02-LAS-299-25.58/25.58
Work Description: BUILDING WORK.
Location Description: LASSEN COUNTY ABOUT 11 MILES EAST OF BIEBER AT THE ADIN MAINTENANCE STATION
Contractor Name: Walsh Construction Company II, LLC (Walsh)
Contractor Address: 1390 Willow Pass Road Suite 950, Concord, CA 94520
Resident Engineer: Mike Zdenek Structure Rep.: Chris Brace

Sample Information

DIME Sample ID: 2021-06-17-41
TL Number from the TL Form: 766442
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: 06/17/2021
Date that the sample was received by the laboratory/organization performing the testing: 06/21/2021
The quantity of what the sample constitutes: PSE 16 Boxes at 91.19 Tons
A brief description of the sample: 1/2 Inch HMA Type A, PG 64-28M Albina
From where was the sample collected: Manufacturer
Laboratory sample identification: D78846
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Eagle Peak Rock and Paving, Alturas, CA

Material Information

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

Test Results

Test 1 of 4

DIME Test ID: 2021-06-17-41-1
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: 2021-06-17-41-2
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: 2021-06-17-41-3
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.

Test 4 of 4

DIME Test ID: 2021-06-17-41-4
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.

Tests Assigned to this Sample

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