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Sample Record for 2021-09-29-19

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Project Information

Project ID: 214397 DEA: 120N3204 EFIS: 1213000196 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-91-R9.8/R18.9
Work Description: CONST PRECAST SLAB REPLACEMENT, COLD PLANE AC PVMT AND PLACE RHMA.
Location Description: ORANGE COUNTY IN ANAHEIM AND YORBA LINDA FROM 0.3 MILE WEST OF LAKEVIEW AVENUE OVERCROSSING TO RIVERSIDE COUNTY LINE
Contractor Name: ACME CONCRETE PAVING INC
Contractor Address: 4124 E BROADWAY AVE, SPOKANE WA 99202
Resident Engineer: Dat Pham Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-09-29-19
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 09/29/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/11/2021
The quantity of what the sample constitutes: 3 Bags of Aggregate
A brief description of the sample: JMF 1/2" HMA-O-SP
From where was the sample collected: Manufacturer
Laboratory sample identification: 0584O-21
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RJ Noble Orange

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-33-0035::EAGLE VALLEY QUARRY
The fabricator's/manufacturer's product name for the sample: 1/2 HMA-O-SP
The fabricator/manufacturer designation for the sample:
The plant number: 43R001SOP
A detailed description of where the material sample was collected: Belt Cut at RJ Noble Orange Plant
Where the material sample would have been placed if not sampled: Asphalt Paving
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test results on following page(s): 6

Test Results

Test 1 of 6

DIME Test ID: 2021-09-29-19-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 10/15/2021
Date Tested: 10/12/2021
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test: Combined Virgin Aggregate Gradation
Test Result Compliance:
Additional Comments When Verified:
What type of gradation is being tested? Combined Gradation
Cumulative percent passing the 2 in. sieve 100 %
Cumulative percent passing the 1 1/2 in. sieve 100 %
Cumulative percent passing the 1 in. sieve 100 %
Cumulative percent passing the 3/4 in. sieve 100 %
Cumulative percent passing the 1/2 in. sieve 96 %
Cumulative percent passing the 3/8 in. sieve 83 %
Cumulative percent passing the #4 sieve 31 %
Cumulative percent passing the #8 sieve 13 %
Cumulative percent passing the #16 sieve 8 %
Cumulative percent passing the #30 sieve 6 %
Cumulative percent passing the #50 sieve 4 %
Cumulative percent passing the #100 sieve 3 %
Cumulative percent passing the #200 sieve 2.3 %

Test 2 of 6

DIME Test ID: 2021-09-29-19-2
Test Method: AASHTO T84-14: Standard Method of Test for Specific Gravity and Absorption of Fine Aggregate (Fine Specific Gravity)
Verified Date: 10/15/2021
Date Tested: 10/13/2021
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Bulk specific gravity 2.616
Bulk specific gravity (SSD Basis) 2.651
Apparent specific gravity 2.711
Absorption 1.3 %

Test 3 of 6

DIME Test ID: 2021-09-29-19-3
Test Method: AASHTO T85-13: Standard Method of Test for Specific Gravity and Absorption of Coarse Aggregate (Coarse Specific Gravity)
Verified Date: 10/15/2021
Date Tested: 10/13/2021
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Basis for relative density testing Bulk
Specific Gravity 2.673
Absorption 0.5 %

Test 4 of 6

DIME Test ID: 2021-09-29-19-4
Test Method: AASHTO T96-02r10: Standard Method of Test for Resistance to Degradation of Small-Size Coarse Aggregate by Abrasion and Impact in the Los Angeles Machine (Los Angeles Rattler)
Verified Date: 10/15/2021
Date Tested: 10/13/2021
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Grading designation C
Mass of sample on No.12 sieve (after 500 revolutions) 4146 grams
Percent loss after 100 revolutions 4 %
Percent loss after 500 revolutions 17 %

Test 5 of 6

DIME Test ID: 2021-09-29-19-7
Test Method: AASHTO T335-09r13: Standard Method of Test for Determining the Percentage of Fracture in Coarse Aggregate (Percent of Crushed Particles)
Verified Date: 10/15/2021
Date Tested: 10/13/2021
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Method 1 - Combined Fracture Determination
Aggregate Size and Fracture Type Coarse 1 and 2 Faced and Fine 1 Faced
Percentage of fractured, coarse, 2 faced particles tested 100 %
Percentage of fractured, coarse, 1 faced particles tested 100 %
Percentage of fractured, fine, 1 faced particles tested 100 %

Test 6 of 6

DIME Test ID: 2021-09-29-19-8
Test Method: ASTM D4791-10: Standard Test Method for Flat Particles, Elongated Particles, or Flat and Elongated Particles in Coarse Aggregate (Withdrawn 2019) (Flat and Elongated Particles)
Verified Date: 10/15/2021
Date Tested: 10/13/2021
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Method B
Determination By Mass
Dimensional ratio used 5:1
Weighted percentage of particles (by mass) that were flat and elongated 4 %
Weighted percentage of particles (by mass) that were not flat and elongated 96 %