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Sample Record for 2015-05-20-10

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

Project Information

Project ID: 209767 DEA: 043G6504 EFIS: 0412000150 QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-680-0.35/13.10
Work Description:
Location Description:
Contractor Name: DESILVA GATES CONSTRUCTION LP
Contractor Address: 11555 DUBLIN BLVD, DUBLIN CA 94568
Resident Engineer: JOYTSNA SHARMA Structure Rep.: Mohammad Nasim

Sample Information

DIME Sample ID: 2015-05-20-10
TL Number from the TL Form: C667691 thru C667696
Sample Submitted By Organization: CT HQ - Sacramento Concrete Testing Laboratory
Sample Organization Contact: (916) 594-1991
Type of Sample: Verification
Type of Material: Job Mix Formula Partial
Sample Taken Date: 05/20/2015
Date that the sample was received by the laboratory/organization performing the testing: 05/27/2015
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: half in HMA
From where was the sample collected: Source
Laboratory sample identification: 15ASPH-0274 thru 15ASPH-0278
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Syar Lake Herman

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-48-0002
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Stockpile
Where the material sample would have been placed if not sampled: Unknown
Superpave or Non-superpave Mix: Superpave
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2015-05-20-10-1
Test Method: AASHTO T85-13: Standard Method of Test for Specific Gravity and Absorption of Coarse Aggregate (Coarse Specific Gravity)
Verified Date: 06/15/2015
Date Tested: 06/10/2015
Submitted By Organization: CT HQ - Sacramento Concrete Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: spencer.adams@dot.ca.gov
Organization Phone: (916) 227-5716
General Comments for this Test:
Test Result Compliance: comply
Additional Comments When Verified:
Basis for relative density testing Bulk
Specific Gravity 2.657
Absorption 2.1 %