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Sample Record for 2022-04-04-4

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Project Information

Project ID: 211848 DEA: 112T2174 EFIS: 1116000131 QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-5-R37.4 - R46.5
Work Description: (Alternative Delivery) CMGC, San Elijo Highway Bridge Replacement. Replace the San Elijo lagoon highway bridge, construct HOV lanes, construct bike and pedestrian trails and bridge, build multi-use facility at Manchester Ave.
Location Description: IN SAN DIEGO COUNTY IN SOLANA BEACH AND ENCINITAS FROM 0.1 MILE NORTH OF LOMAS SANTA FE DRIVE OVERCROSSING TO 0.2 MILE SOUTH OF BIRMINGHAM DRIVE OVERCROSSING
Contractor Name: Flatiron-Skanska-Stacy and Witbeck, a Joint Venture
Contractor Address: 1770 La Costa Meadows Drive, San Marcos, CA 92078
Resident Engineer: Steve McMillan Structure Rep.: Phong Le

Sample Information

DIME Sample ID: 2022-04-04-4
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: Hot Mix Asphalt
Sample Taken Date: 04/04/2022
Date that the sample was received by the laboratory/organization performing the testing: 04/05/2022
The quantity of what the sample constitutes: 8 boxes, 3 bags
A brief description of the sample: 3/4" HMA PSU
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CCA Lakeside

Material Information

HMA Type: Type A HMA
HMA Grading: 3/4 inch
Lot number:
Sublot number:
HMA Mix Number:

Test Results

Test 1 of 6

DIME Test ID: 2022-04-04-4-1
Test Method: AASHTO T308-10: Standard Method of Test for Determining the Asphalt Binder Content of Hot Mix Asphalt (HMA) by the Ignition Method (Method A) (Asphalt Binder Content)
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
Data has not been verified.

Test 2 of 6

DIME Test ID: 2022-04-04-4-2
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
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
Data has not been verified.

Test 3 of 6

DIME Test ID: 2022-04-04-4-3
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)
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
Data has not been verified.

Test 4 of 6

DIME Test ID: 2022-04-04-4-4
Test Method: AASHTO T269-14: Standard Method of Test for Percent Air Voids in Compacted Dense and Open Asphalt Mixtures (Air Void)
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
Data has not been verified.

Test 5 of 6

DIME Test ID: 2022-04-04-4-5
Test Method: AASHTO T308-10: Standard Method of Test for Determining the Asphalt Binder Content of Hot Mix Asphalt (HMA) by the Ignition Method (Method A) (Asphalt Binder Content)
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
Data has not been verified.

Test 6 of 6

DIME Test ID: 2022-04-04-4-6
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
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
Data has not been verified.