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Sample Record for 2021-08-23-30

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

Project Information

Project ID: 215494 DEA: 081H4904 EFIS: 0817000059 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-18-31.9/38.5
Work Description: COLD PLANE AC PAVEMENT AND OVERLAY WITH HMA (TYPE A).
Location Description: SAN BERNARDINO COUNTY FROM 0.1 MILE EAST OF HILLTOP CONNECTOR TO 0.5 MILE EAST OF SIBERIA CREEK TRAIL
Contractor Name: Matich Corp
Contractor Address: P.O. Box 10, Highland, CA 92346-1010
Resident Engineer: Nhan Nguyen Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-08-23-30
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: (951) 840-8328
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 08/23/2021
Date that the sample was received by the laboratory/organization performing the testing: 08/23/2021
The quantity of what the sample constitutes: 2 box, 3 cores
A brief description of the sample: HMA Type A R12 # LHP62-D
From where was the sample collected: Manufacturer
Laboratory sample identification: 19A, 19B, 19C
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Matich Lytle Creek

Material Information

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

Test Results

Test 1 of 2

DIME Test ID: 2021-08-23-30-1
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: 09/02/2021
Date Tested: 08/31/2021
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria St,
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:
Additional Comments When Verified:
Bulk Specific Gravity 2.282
Bulk Specific Gravity 2 2.284
Bulk Specific Gravity 3 2.328
Average Bulk Specific Gravity 2.298

Test 2 of 2

DIME Test ID: 2021-08-23-30-2
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: 09/02/2021
Date Tested: 08/23/2021
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria St,
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:
Additional Comments When Verified:
Number of tests 1
Mass Determination Water
Specific Gravity for Sample 1 2.502

Tests Assigned to this Sample

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