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Sample Record for 2021-10-18-30

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

Project Information

Project ID: 215188 DEA: 080F5434 EFIS: 0817000239 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-I-15,SR-91-6.1-7.6
Work Description: I-15 ELC: 15/91 Express Lanes Connector Project (ELC)
Location Description: Junction of I-15 and SR-91 in Corona, CA
Contractor Name: Myers-Rados Joint Venture
Contractor Address: 629 N. Main Street, Suite C3, Corona, CA 92878
Resident Engineer: Roy Fisher Structure Rep.: Luis Negrete

Sample Information

DIME Sample ID: 2021-10-18-30
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: 10/18/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/21/2021
The quantity of what the sample constitutes: 2 boxes, 3 cores
A brief description of the sample: 3/4" HMA-A #105793
From where was the sample collected: Job Site
Laboratory sample identification: 1A3, 1B3, 1C3
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: All American Asphalt Corona

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: 2021-10-18-30-1
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: 10/28/2021
Date Tested: 10/25/2021
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
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:
Additional Comments When Verified:
Bulk Specific Gravity 2.337
Bulk Specific Gravity 2 2.321
Bulk Specific Gravity 3 2.327
Average Bulk Specific Gravity 2.328

Test 2 of 2

DIME Test ID: 2021-10-18-30-2
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: 10/28/2021
Date Tested: 10/24/2021
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
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:
Additional Comments When Verified:
Number of tests 1
Mass Determination Water
Specific Gravity for Sample 1 2.483

Tests Assigned to this Sample

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