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Sample Record for 2022-04-13-22

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

Project Information

Project ID: 215236 DEA: 081C6804 EFIS: 0812000343 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-74,79and371-Varies
Work Description: REPLACE STRUCTURAL CONCRETE BRIDGE, RETAINING WALL AND BOX CULVERT.
Location Description: RIVERSIDE COUNTY AT VARIOUS LOCATIONS
Contractor Name: Ortiz Enterprise
Contractor Address: 6 Cushing, Suite 200, Irvine, Ca 92618-4221
Resident Engineer: Nick Truong Structure Rep.: Arnel L. Vega

Sample Information

DIME Sample ID: 2022-04-13-22
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: (951) 840-8328
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 04/13/2022
Date that the sample was received by the laboratory/organization performing the testing: 04/13/2022
The quantity of what the sample constitutes: 2 boxes
A brief description of the sample: HMA-A 3/4" PG 64-28M #53417615
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CCA Lake Elsinore

Material Information

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

Test Results

Test 1 of 1

DIME Test ID: 2022-04-13-22-1
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Verified Date: 04/15/2022
Date Tested: 04/15/2022
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
Number of tests 1
What is the unit of measurement for theoretical density? US Units
Mass Determination Air
Method Performed Mechanical Agitation - Method A
Mass of container filled with water 7400.8 grams
Mass of oven-dry sample in air for Sample 1 2501.2 grams
Mass of container filled with the sample and water for Sample 1 8877.3 grams
Temperature of Water 77 °F
Specific Gravity for Sample 1 2.441
Theoretical maximum density at 25°C (77°F) no data