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Sample Record for 2022-03-29-28

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Project Information

Project ID: 213811 DEA: 112T2184 EFIS: 1116000174 QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-5-R38.4/R47.3
Work Description: (Alternative Delivery) Construct HOV lanes, soundwalls, culvert rehab, ITS, and bike trail on I-5 . NCC I-5 Highway Improvement.
Location Description: IN SAN DIEGO COUNTY IN ENCINITAS AND CARLSBAD FROM SAN ELIJO LAGOON BRIDGE TO 0.3 MILE NORTH OF PALOMAR AIRPORT ROAD OVERCROSSING.
Contractor Name: Flatiron-Skanska-Stacy and Witbeck, a Joint Venture
Contractor Address: 1525 Faraday Ave. #180, Carlsbad, CA 92008
Resident Engineer: Yong Pak Structure Rep.: Cailyn Le

Sample Information

DIME Sample ID: 2022-03-29-28
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: 03/29/2022
Date that the sample was received by the laboratory/organization performing the testing: 03/30/2022
The quantity of what the sample constitutes: 5 bags, 12 boxes, 4 cans
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: Vulcan Carroll Canyon

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-37-0035
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: Plant
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 on following page(s): 6

Test Results

Test 1 of 6

DIME Test ID: 2022-03-29-28-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
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: 2022-03-29-28-2
Test Method: AASHTO T335-09r13: Standard Method of Test for Determining the Percentage of Fracture in Coarse Aggregate (Percent of Crushed Particles)
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: 2022-03-29-28-3
Test Method: ASTM D4791-10: Standard Test Method for Flat Particles, Elongated Particles, or Flat and Elongated Particles in Coarse Aggregate (Withdrawn 2019) (Flat and Elongated Particles)
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: 2022-03-29-28-4
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)
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: 2022-03-29-28-7
Test Method: AASHTO T85-13: Standard Method of Test for Specific Gravity and Absorption of Coarse Aggregate (Coarse 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 6 of 6

DIME Test ID: 2022-03-29-28-10
Test Method: AASHTO T30-19: Standard Method of Test for Mechanical Analysis of Extracted Aggregate (Mechanical Analysis)
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.

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
2022-03-29-28-5CTM 204-June 2010: Method of Test for Liquid Limit, Plastic Limit and Plasticity Index of Soils (Plasticity Index)04/08/202204/08/2022Melchor OronozCT D11 - District 11 Materials LaboratoryMohammad Abbassi
2022-03-29-28-6AASHTO T84-14: Standard Method of Test for Specific Gravity and Absorption of Fine Aggregate (Fine Specific Gravity)04/08/202204/08/2022Melchor OronozCT D11 - District 11 Materials LaboratoryMohammad Abbassi
2022-03-29-28-8AASHTO T96-02r10: Standard Method of Test for Resistance to Degradation of Small-Size Coarse Aggregate by Abrasion and Impact in the Los Angeles Machine (Los Angeles Rattler)04/08/202204/08/2022Melchor OronozCT D11 - District 11 Materials LaboratoryMohammad Abbassi
2022-03-29-28-9AASHTO T304-11: Standard Method of Test for Uncompacted Void Content of Fine Aggregate (Fine of Crushed Particles)04/08/202204/08/2022Melchor OronozCT D11 - District 11 Materials LaboratoryMohammad Abbassi