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Sample Record for 2022-07-26-25

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Project Information

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

Sample Information

DIME Sample ID: 2022-07-26-25
TL Number from the TL Form: C072622A
Sample Submitted By Organization: CT D07 - Plant Services
Sample Organization Contact: 562-345-3126
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 07/26/2022
Date that the sample was received by the laboratory/organization performing the testing: 07/26/2022
The quantity of what the sample constitutes: 100 Tons
A brief description of the sample: 3/8" HMA type A
From where was the sample collected: Manufacturer
Laboratory sample identification: KH201A
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Materials Sun Valley #2

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-19-0021
The fabricator's/manufacturer's product name for the sample: CT Dike Mix 63763-2
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: HMA Hot Bins
Where the material sample would have been placed if not sampled: Roadbed
Primary Aggregate Nominal Size: 3/8 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2022-07-26-25-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 08/11/2022
Date Tested: 07/26/2022
Submitted By Organization: CT D07 - Plant Services
Organization Address: 13230 East Firestone Boulevard, Suite G,
Organization City: Santa Fe Springs
Organization State: CA
Organization Zipcode: 90670
Organization Email: victor.zengler@dot.ca.gov
Organization Phone: (562) 345-3126
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
What type of gradation is being tested? Combined Gradation
Cumulative percent passing the 2 in. sieve 100 %
Cumulative percent passing the 1 1/2 in. sieve 100 %
Cumulative percent passing the 1 in. sieve 100 %
Cumulative percent passing the 3/4 in. sieve 100 %
Cumulative percent passing the 1/2 in. sieve 100 %
Cumulative percent passing the 3/8 in. sieve 99 %
Cumulative percent passing the #4 sieve 82 %
Cumulative percent passing the #8 sieve 63 %
Cumulative percent passing the #16 sieve 44 %
Cumulative percent passing the #30 sieve 29 %
Cumulative percent passing the #50 sieve 19 %
Cumulative percent passing the #100 sieve 11 %
Cumulative percent passing the #200 sieve 5 %

Test 2 of 3

DIME Test ID: 2022-07-26-25-2
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)
Verified Date: 08/11/2022
Date Tested: 07/26/2022
Submitted By Organization: CT D07 - Plant Services
Organization Address: 13230 East Firestone Boulevard, Suite G,
Organization City: Santa Fe Springs
Organization State: CA
Organization Zipcode: 90670
Organization Email: victor.zengler@dot.ca.gov
Organization Phone: (562) 345-3126
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Sand Equivalent 70

Test 3 of 3

DIME Test ID: 2022-07-26-25-3
Test Method: AASHTO T11-5: Standard Method of Test for Materials Finer Than 75-μm (No. 200) Sieve in Mineral Aggregates by Washing
Verified Date: 08/11/2022
Date Tested: 07/26/2022
Submitted By Organization: CT D07 - Plant Services
Organization Address: 13230 East Firestone Boulevard, Suite G,
Organization City: Santa Fe Springs
Organization State: CA
Organization Zipcode: 90670
Organization Email: victor.zengler@dot.ca.gov
Organization Phone: (562) 345-3126
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Which test procedure is being used Method A
Percent of sample passing the #200 sieve (by mass) 5.8 %