Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214573 DEA: 073096U4 EFIS: 0719000091
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-210-R0.0/R9.7
Work Description: PLACE CONCRETE PAVEMENT, BARRIER, HMA, DRAINAGE, AND ELECTRICAL.
Location Description: LOS ANGELES COUNTY IN LOS ANGELES FROM INTERSTATE 5 TO WHEATLAND AVENUE UNDERCROSSING
Contractor Name: FLATIRON WEST INC
Contractor Address: 15335 FAIRFIELD RANCH ROAD, CHINO HILLS, CA 91709
Resident Engineer: Ridwan Salman Structure Rep.: Adriana Pimienta
DIME Sample ID: 2021-12-18-6
TL Number from the TL Form: na
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: 12/18/2021
Date that the sample was received by the laboratory/organization performing the testing: 03/21/2022
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4" hma - a220831 sva ltr
From where was the sample collected: Job Site
Laboratory sample identification: 22-0072
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Sun Valley
DIME Test ID: 2021-12-18-6-1
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: 03/24/2022
Date Tested: 03/22/2022
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
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
|
Bulk Specific Gravity
|
2.440
|
|
Bulk Specific Gravity 2
|
2.428
|
|
Bulk Specific Gravity 3
|
2.434
|
|
Average Bulk Specific Gravity
|
2.434
|
