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Sample Record for 2022-03-17-22

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

Project Information

Project ID: 66667 DEA: JMFPP EFIS: 0019000043 QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for JMF Prequalification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2022-03-17-22
TL Number from the TL Form: 708110
Sample Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Sample Organization Contact: (530) 225-3194
Type of Sample: Annual Source Testing
Type of Material: Aggregate
Sample Taken Date: 03/17/2022
Date that the sample was received by the laboratory/organization performing the testing: 03/21/2022
The quantity of what the sample constitutes: JMF Verification
A brief description of the sample: 3 bags of Untreated 5/8″ Sized Virgin Aggregate for use in 3/4-inch Type A HMA
From where was the sample collected: Manufacturer
Laboratory sample identification: D79009A
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Tullis – Northstate Asphalt (Redding, CA)

Material Information

Source Identification (SMARA or name of Pit): 91-45-0057::Shasta Ranch Aggregates
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: Sized Untreated Aggregate Stockpile
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:

Test Results

Test 1 of 2

DIME Test ID: 2022-03-17-22-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 04/18/2022
Date Tested: 03/22/2022
Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Organization Address: 1657 Riverside Drive,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: 530-225-3194
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
What type of gradation is being tested? HMA Gradation
Does this test use 1/4 sieve? (question for HMA Gradation Type) Yes
Has the fine aggregate sample been reduced? No
Total mass of material in the sample 5291.5 grams
Cumulative mass retained on the 1 1/2 in. sieve 0 grams
Cumulative mass retained on the 1 in. sieve 24 grams
Cumulative mass retained on the 3/4 in. sieve 24 grams
Cumulative mass retained on the 1/2 in. sieve 1200 grams
Cumulative mass retained on the 3/8 in. sieve 3910 grams
Cumulative mass retained on the 1/4 in. sieve 5130 grams
Cumulative mass retained on the #4 sieve 5171 grams
Cumulative mass retained on the #8 sieve 32.8 grams
Cumulative mass retained on the #16 sieve 46.7 grams
Cumulative mass retained on the #30 sieve 54.9 grams
Cumulative mass retained on the #50 sieve 62.9 grams
Cumulative mass retained on the #100 sieve 71.8 grams
Cumulative mass retained on the #200 sieve 80.5 grams
Cumulative mass retained on the pan no data
Cumulative percent passing the 1 1/2 in. sieve 100 %
Cumulative percent passing the 1 in. sieve 99.5 %
Cumulative percent passing the 3/4 in. sieve 99.5 %
Cumulative percent passing the 1/2 in. sieve 77.3 %
Cumulative percent passing the 3/8 in. sieve 26.1 %
Cumulative percent passing the 1/4 in. sieve 3.1 %
Cumulative percent passing the #4 sieve 2.3 %
Cumulative percent passing the #8 sieve 1.7 %
Cumulative percent passing the #16 sieve 1.4 %
Cumulative percent passing the #30 sieve 1.3 %
Cumulative percent passing the #50 sieve 1.1 %
Cumulative percent passing the #100 sieve 0.9 %
Cumulative percent passing the #200 sieve 0.76 %

Test 2 of 2

DIME Test ID: 2022-03-17-22-2
Test Method: AASHTO T104-99r16: Standard Method of Test for Soundness of Aggregate by Use of Sodium Sulfate or Magnesium Sulfate (Soundness)
Verified Date: 05/04/2022
Date Tested: 05/02/2022
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sac
Organization State: CA
Organization Zipcode: 95819
Organization Email: bang.d.nguyen@dot.ca.gov
Organization Phone: (916) 227-7204
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Size of aggregate being tested Coarse Aggregate
What type of solution was used? Sodium sulfate
What was the condition of the solution? Previously used
Number of immersion cycles performed 5
Coarse weighted average loss 0.7 %