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Sample Record for 2022-04-06-57

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

Project Information

Project ID: 213707 DEA: 081C38U4 EFIS: 0817000196 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-10-6.7/R25.1
Work Description: Remove concrete pavement and base, and place HMA and JPCP
Location Description: ROUTE 10/60 SEPARATION IN BEAUMONT TO ROUTE 10/111 SEPARATION NEAR CABAZON.
Contractor Name: Coffman Specialties
Contractor Address: 9685 Via Excelencia, San Diego, CA 92126
Resident Engineer: Elvira Lenart Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2022-04-06-57
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: 9512323690
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 04/06/2022
Date that the sample was received by the laboratory/organization performing the testing: 04/07/2022
The quantity of what the sample constitutes: 2 boxes, 8 Cores
A brief description of the sample: HMA-A 3/4" R24 PG 58-34M
From where was the sample collected: Manufacturer
Laboratory sample identification: 268-A,268-B,268-C,269-A,269-B,269-C,270-A,270-B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CCA Coachella

Material Information

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

Test Results

Test 1 of 4

DIME Test ID: 2022-04-06-57-1
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: 10/07/2022
Date Tested: 04/25/2022
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: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Number of tests 1
What is the unit of measurement for theoretical density? US Units
Mass Determination Air
Specific Gravity for Sample 1 2.490
Theoretical maximum density at 25°C (77°F) 155.0 lb/ft^3

Test 2 of 4

DIME Test ID: 2022-04-06-57-2
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: 10/07/2022
Date Tested: 04/07/2022
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: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test: Cores 268-A, 268-B, 268-C
Test Result Compliance:
Additional Comments When Verified:
Bulk Specific Gravity 2.356
Bulk Specific Gravity 2 2.365
Bulk Specific Gravity 3 2.360
Average Bulk Specific Gravity 2.36

Test 3 of 4

DIME Test ID: 2022-04-06-57-3
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: 10/07/2022
Date Tested: 04/07/2022
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: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test: Cores 269-A, 269-B, 269-C
Test Result Compliance:
Additional Comments When Verified:
Bulk Specific Gravity 2.294
Bulk Specific Gravity 2 2.360
Bulk Specific Gravity 3 2.350
Average Bulk Specific Gravity 2.335

Test 4 of 4

DIME Test ID: 2022-04-06-57-4
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: 10/07/2022
Date Tested: 04/07/2022
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: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test: Cores 270-B, 270-C
Test Result Compliance:
Additional Comments When Verified:
Bulk Specific Gravity 2.295
Bulk Specific Gravity 2 2.360
Average Bulk Specific Gravity 2.328