Project Information

Project ID: 215587 DEA: 081L6804 EFIS: 0820000138 QA Service Level: 1

DIST-CO-RTE-PM: 08-RIV-91,15-7.5/13.4,8.2/23.9

Work Description: SLAB REPLACEMENT, PLACE SLURRY SEAL AND REPLACE AC SURFACING.

Location Description: RIVERSIDE COUNTY IN AND NEAR CORONA AND MURRIETA ON ROUTE 91 FROM ROUTE 15/91 SEPARATION TO 0.4 MILE EAST OF TYLER STREET AND ON ROUTE 15 FROM 1.5 MILES NORTH OF WINCHESTER ROAD TO NICHOLS ROAD

Contractor Name: RV Concrete

Contractor Address: 605 E Commercial Street, Anaheim, CA 92801

Resident Engineer: Denise Sostrom Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-11-09-26

TL Number from the TL Form:

Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory

Sample Organization Contact: 9512323690

Type of Sample: Department Acceptance

Type of Material: Aggregate

Sample Taken Date: 11/09/2021

Date that the sample was received by the laboratory/organization performing the testing: 11/10/2021

The quantity of what the sample constitutes: 1 bag combined aggregate

A brief description of the sample: AC Drum Aggregate

From where was the sample collected: Manufacturer

Laboratory sample identification:

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: AAA-Corona

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-33-0005

The fabricator's/manufacturer's product name for the sample:

The fabricator/manufacturer designation for the sample:

The plant number:

A detailed description of where the material sample was collected: belt an chute

Where the material sample would have been placed if not sampled:

Primary Aggregate Nominal Size: 3/4 inch

The concrete mix design number: 103793

Lot number:

Sublot number:

Aggregate Mix Number:

Test Results

Test 1 of 2

DIME Test ID: 2021-11-09-26-1

Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)

Verified Date: 11/24/2021

Date Tested: 11/15/2021

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: prakash.gowda@dot.ca.gov

Organization Phone: (951) 232-3690

General Comments for this Test:

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	97 %
Cumulative percent passing the 1/2 in. sieve	85 %
Cumulative percent passing the 3/8 in. sieve	72 %
Cumulative percent passing the #4 sieve	48 %
Cumulative percent passing the #8 sieve	29 %
Cumulative percent passing the #16 sieve	19 %
Cumulative percent passing the #30 sieve	12 %
Cumulative percent passing the #50 sieve	7 %
Cumulative percent passing the #100 sieve	5 %
Cumulative percent passing the #200 sieve	3.2 %

Test 2 of 2

DIME Test ID: 2021-11-09-26-2

Test Method: AASHTO T176-08: Standard Method of Test for Plastic Fines in Graded Aggregates and Soils by Use of the Sand Equivalent Test (Sand Equivalent)