Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993592 DEA: 120S8704 EFIS: 1221000056
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-55-0.2/T2.4
Work Description: COLD PLANE AC PAVEMENT AND PLACE RHMA-G.
Location Description: ORANGE COUNTY IN NEWPORT BEACH AND COSTA MESA FROM JUNCTION ROUTE 1 TO 0.4 MILE NORTH OF 19TH STREET
Contractor Name: CALMEX ENGINEERING INC.
Contractor Address: 2764 S VISTA AVE, BLOOMINGTON, CA 92316
Resident Engineer: Jay Joubeen Structure Rep.: Unknown
DIME Sample ID: 2022-09-12-62
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 09/12/2022
Date that the sample was received by the laboratory/organization performing the testing: 11/01/2022
The quantity of what the sample constitutes: 3 Boxes RHMA ,4 Qts LTR64-16,Qts Rubber Blend, 1 Qt Extender Oil, 8 Bags of Combined Agg.
A brief description of the sample: PSUE 1/2"" RHMA-G-SP 0.8% LAS
From where was the sample collected: Source
Laboratory sample identification: 0719-22
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Fish Canyon - Irwindale
Source Identification (SMARA, name of Pit or Job Site): 91-19-0035
The fabricator's/manufacturer's product name for the sample: Vulcan Irwindale
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Aggregate
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number: 326120A
Lot number:
Sublot number:
Aggregate Mix Number:
DIME Test ID: 2022-09-12-62-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
DIME Test ID: 2022-09-12-62-2
Test Method: AASHTO T84-14: Standard Method of Test for Specific Gravity and Absorption of Fine Aggregate (Fine Specific Gravity)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
DIME Test ID: 2022-09-12-62-3
Test Method: AASHTO T85-13: Standard Method of Test for Specific Gravity and Absorption of Coarse Aggregate (Coarse Specific Gravity)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
DIME Test ID: 2022-09-12-62-4
Test Method: AASHTO T96-02r10: Standard Method of Test for Resistance to Degradation of Small-Size Coarse Aggregate by Abrasion and Impact in the Los Angeles Machine (Los Angeles Rattler)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
DIME Test ID: 2022-09-12-62-5
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)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
DIME Test ID: 2022-09-12-62-6
Test Method: AASHTO T304-11: Standard Method of Test for Uncompacted Void Content of Fine Aggregate (Fine of Crushed Particles)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
DIME Test ID: 2022-09-12-62-7
Test Method: AASHTO T335-09r13: Standard Method of Test for Determining the Percentage of Fracture in Coarse Aggregate (Percent of Crushed Particles)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
DIME Test ID: 2022-09-12-62-8
Test Method: ASTM D4791-10: Standard Test Method for Flat Particles, Elongated Particles, or Flat and Elongated Particles in Coarse Aggregate (Withdrawn 2019) (Flat and Elongated Particles)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
