Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993340 DEA: 051J7504 EFIS: 0518000039 MINOR: 05A2318
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-90
Work Description: Install CMS Sign Structure US 101 NB 0.3 Miles N of Donovan Rd
Location Description: In Santa Maria
Contractor Name: Pelagic Engineering
Contractor Address: 3600 Harbor Blvd #85, Oxnard, CA 93035
Resident Engineer: Thomas Petersen Structure Rep.: Alex Martinez
DIME Sample ID: 2022-10-06-34
TL Number from the TL Form:
Sample Submitted By Organization: CT D05 - Santa Maria Field Laboratory
Sample Organization Contact:
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/06/2022
Date that the sample was received by the laboratory/organization performing the testing: 10/06/2022
The quantity of what the sample constitutes: 1 Sublot
A brief description of the sample: 1/2" HMA A Coldfeed
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sierra Pacific Materials - Templeton
DIME Test ID: 2022-10-06-34-1
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: 11/01/2022
Date Tested: 10/07/2022
Submitted By Organization: CT D05 - Santa Maria Field Laboratory
Organization Address: 2053 Preisker Lane, Suite E,
Organization City: Santa Maria
Organization State: CA
Organization Zipcode: 93427
Organization Email: salvador.lopez-zamora@dot.ca.gov
Organization Phone: (805) 748-3854
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
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Number of tests
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1
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What is the unit of measurement for theoretical density?
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US Units
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Mass Determination
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Water
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Specific Gravity for Sample 1
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2.422
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Theoretical maximum density at 25°C (77°F)
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62.4 lb/ft^3
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