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Sample Record for 2021-11-13-10

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Project Information

Project ID: 7613 DEA: 071218W4 EFIS: 0700021119 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-29.4/31.6
Work Description: REALIGN ROUTE 5 AND RAILROAD TRACKS AND RECONFIGURE ON- AND OFF-RAMPS.
Location Description: LOS ANGELES COUNTY IN BURBANK FROM WEST MAGNOLIA BOULEVARD OVERCROSSING TO 0.3 MILE NORTH OF BUENA VISTA STREET/WINONA AVENUE UNDERCROSSING
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 13170 TELFAIR AVENUE, SYLMAR, CA 91342
Resident Engineer: Vladimir Gurfinkel Structure Rep.: Gon Choi

Sample Information

DIME Sample ID: 2021-11-13-10
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: Per Request
Type of Material: Asphalt Rubber Binder
Sample Taken Date: 11/13/2021
Date that the sample was received by the laboratory/organization performing the testing: 11/16/2021
The quantity of what the sample constitutes: 1 Quart Can
A brief description of the sample: Asphalt Rubber Binder
From where was the sample collected: Supplier
Laboratory sample identification: 0637-21
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan-Sun Valley

Material Information

Asphalt modifier supplier:
Performance Grade: PG 64-16
Lot number:
Sublot number:
Asphalt Rubber Binder Mix Number:

Test Results

Test 1 of 3

DIME Test ID: 2021-11-13-10-2
Test Method: ASTM D5329-16: Standard Test Methods for Sealants and Fillers, Hot-Applied, for Joints and Cracks in Asphalt Pavements and Portland Cement Concrete Pavements (Asphalt Pavement)
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
Data has not been verified.

Test 2 of 3

DIME Test ID: 2021-11-13-10-3
Test Method: ASTM D36-14ε1: Standard Test Method for Softening Point of Bitumen (Ring-and-Ball Apparatus) (Softening Point)
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
Data has not been verified.

Test 3 of 3

DIME Test ID: 2021-11-13-10-4
Test Method: ASTM D217-16: Standard Test Methods for Cone Penetration of Lubricating Grease (Cone Penetration)
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
Data has not been verified.