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Sample Record for 2021-10-29-19

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

Project Information

Project ID: 215083 DEA: 07307504 EFIS: 0714000217 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-101-11.8/31.1
Work Description: PLACE RHMA-G, MODIFY RAMP METERING AND SIGNAL AND LIGHTING SYSTEMS.
Location Description: LOS ANGELES COUNTY FROM TUJUNGA AVENUE UNDERCROSSING TO LAS VIRGENES ROAD OVERCROSSING
Contractor Name: Alfaro Communication
Contractor Address: 15614 South Atlantic Avenue, Compton, CA 90221
Resident Engineer: Arturo Lao Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-10-29-19
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/29/2021
Date that the sample was received by the laboratory/organization performing the testing: 11/02/2021
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: RHMA CORES
From where was the sample collected: Job Site
Laboratory sample identification: 21-0402
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Materials Sun Valley 3

Material Information

HMA Type: RHMA-G
HMA Grading: 3/4 inch
Lot number: 2
Sublot number: 12
HMA Mix Number:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2021-10-29-19-1
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)
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 817-0387
Data has not been verified.

Test 2 of 2

DIME Test ID: 2021-10-29-19-2
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 D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 817-0387
Data has not been verified.