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Sample Record for 2022-12-07-39

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

Project Information

Project ID: 214438 DEA: 080G6914 EFIS: 0815000184 QA Service Level: 1
DIST-CO-RTE-PM: 08---
Work Description: RELINE OR REPLACE CULVERTS
Location Description: SAN BERNARDINO COUNTY IN AND NEAR SAN BERNARDINO FROM 48TH STREET TO ROUTE 18/138 SEPARATION
Contractor Name: SUKUT CONSTRUCTION, LLC.
Contractor Address: Unknown
Resident Engineer: NHAN NGUYEN Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2022-12-07-39
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: (951) 840-8328
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 12/07/2022
Date that the sample was received by the laboratory/organization performing the testing: 12/16/2022
The quantity of what the sample constitutes: 1 boxes, 1 Cores
A brief description of the sample: 3/4" HMA-A-SP R12 0.75%LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 1C
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Matich Plant Rialto

Material Information

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

Test Results

Test 1 of 2

DIME Test ID: 2022-12-07-39-1
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: 12/22/2022
Date Tested: 12/21/2022
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: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
Test Result Compliance:
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 2.487
Theoretical maximum density at 25°C (77°F) 154.8 lb/ft^3

Test 2 of 2

DIME Test ID: 2022-12-07-39-2
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: 12/22/2022
Date Tested: 12/22/2022
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: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test: Core 1C
Test Result Compliance:
Additional Comments When Verified:
Bulk Specific Gravity 2.321