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Sample Record for 2021-11-17-30

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Project Information

Project ID: 215360 DEA: 112N0454 EFIS: 1118000198 QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-94-30.0/39.0
Work Description: PLACING CHIP SEAL, SLURRY SEAL, SHOULDER BACKING AND STRIPING.
Location Description: SAN DIEGO COUNTY NEAR DULZURA AND BARRETT JUNCTION FROM 0.9 MILE EAST OF GRANDE CREEK BRIDGE TO ROUTE 188.
Contractor Name: American Pavement Systems, Inc.
Contractor Address: 1012 11th Street, Suite 1000, Modesto, CA 95354
Resident Engineer: Benjamin Haney Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-11-17-30
TL Number from the TL Form:
Sample Submitted By Organization: CT D11 - District 11 Materials Laboratory
Sample Organization Contact: (858) 688-1570
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 11/17/2021
Date that the sample was received by the laboratory/organization performing the testing: 11/26/2021
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: Slurry type III
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Not Provided

Material Information

Source Identification (SMARA, name of Pit or Job Site): Not Provided
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: Slurry Type III
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/8 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:

Test Results

Test 1 of 3

DIME Test ID: 2021-11-17-30-1
Test Method: AASHTO T11-5: Standard Method of Test for Materials Finer Than 75-μm (No. 200) Sieve in Mineral Aggregates by Washing
Verified Date: 01/11/2022
Date Tested: 01/27/2022
Submitted By Organization: CT D11 - District 11 Materials Laboratory
Organization Address: 7177 Opportunity Road,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92111
Organization Email: dave.m.cortez@dot.ca.gov
Organization Phone: (858) 688-1570
General Comments for this Test: Pass
Test Result Compliance: not applicable
Additional Comments When Verified:
Which test procedure is being used Method A
Percent of sample passing the #200 sieve (by mass) 84.8 %

Test 2 of 3

DIME Test ID: 2021-11-17-30-3
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)
Verified Date: 01/11/2022
Date Tested: 01/04/2022
Submitted By Organization: CT D11 - District 11 Materials Laboratory
Organization Address: 7177 Opportunity Road,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92111
Organization Email: dave.m.cortez@dot.ca.gov
Organization Phone: (858) 688-1570
General Comments for this Test: Pass
Test Result Compliance: complies
Additional Comments When Verified:
Sand Equivalent 68

Test 3 of 3

DIME Test ID: 2021-11-17-30-4
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 01/11/2022
Date Tested: 01/11/2022
Submitted By Organization: CT D11 - District 11 Materials Laboratory
Organization Address: 7177 Opportunity Road,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92111
Organization Email: dave.m.cortez@dot.ca.gov
Organization Phone: (858) 688-1570
General Comments for this Test: Pass
Test Result Compliance: complies
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 100 %
Cumulative percent passing the 3/8 in. sieve 100 %
Cumulative percent passing the #4 sieve 90 %
Cumulative percent passing the #8 sieve 61 %
Cumulative percent passing the #16 sieve 40 %
Cumulative percent passing the #30 sieve 28 %
Cumulative percent passing the #50 sieve 18 %
Cumulative percent passing the #100 sieve 13 %
Cumulative percent passing the #200 sieve 9 %