Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993587 DEA: 061C3704 EFIS: 0621000163
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE,TUL-180,245-108.0/110.8,0.0/9.0
Work Description: COLD PLANE AC AND PLACE HMA (TYPE A).
Location Description: FRESNO AND TULARE COUNTIES ON ROUTE 180 FROM 0.1 MILE WEST OF ROUTE 245 TO 1.3 MILES EAST OF FRESNO COUNTY LINE AND ON ROUTE 245 FROM TULARE COUNTY LINE TO ?ROUTE 180
Contractor Name: Cal Valley Construction
Contractor Address: 5125 N. Gates Ave., Ste. 102, Fresno, CA, 93722-6414
Resident Engineer: Mark Mengoni Structure Rep.: Unknown
DIME Sample ID: 2022-08-11-69
TL Number from the TL Form: c027129
Sample Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Dispute Resolution
Type of Material: Hot Mix Asphalt
Sample Taken Date: 08/11/2022
Date that the sample was received by the laboratory/organization performing the testing: 09/09/2022
The quantity of what the sample constitutes: 1 core
A brief description of the sample: compaction core
From where was the sample collected: Job Site
Laboratory sample identification: 022-043
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Cal Valley Construction
DIME Test ID: 2022-08-11-69-1
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)
Verified Date: 09/14/2022
Date Tested: 09/12/2022
Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Organization Address: 5900 Folsom Boulevard, Room 225,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (916) 227-7302
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Bulk Specific Gravity
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2.417
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