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Sample Record for 2022-10-20-74

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

Project Information

Project ID: 66667 DEA: JMFPP EFIS: 0019000043 QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for JMF Prequalification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2022-10-20-74
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Informational
Type of Material: Aggregate
Sample Taken Date: 10/20/2022
Date that the sample was received by the laboratory/organization performing the testing: 01/26/2023
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: 1/2 Aggregate
From where was the sample collected: Source
Laboratory sample identification: 23-JMF-0005
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Legrand Rock & Asphalt, Inc.

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-24-0007
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Belt cut
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2022-10-20-74-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 02/01/2023
Date Tested: 02/01/2023
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bang.d.nguyen@dot.ca.gov
Organization Phone: (916) 227-7204
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
What type of gradation is being tested? HMA Gradation
Cumulative percent passing the 1 1/2 in. sieve 100 %
Cumulative percent passing the 1 in. sieve 100 %
Cumulative percent passing the 3/4 in. sieve 100 %
Cumulative percent passing the 1/2 in. sieve 95 %
Cumulative percent passing the 3/8 in. sieve 86 %
Cumulative percent passing the 1/4 in. sieve 100 %
Cumulative percent passing the #4 sieve 40 %
Cumulative percent passing the #8 sieve 22 %
Cumulative percent passing the #16 sieve 14 %
Cumulative percent passing the #30 sieve 10 %
Cumulative percent passing the #50 sieve 7 %
Cumulative percent passing the #100 sieve 5 %
Cumulative percent passing the #200 sieve 3.7 %

Test 2 of 3

DIME Test ID: 2022-10-20-74-2
Test Method: AASHTO T85-13: Standard Method of Test for Specific Gravity and Absorption of Coarse Aggregate (Coarse Specific Gravity)
Verified Date: 02/01/2023
Date Tested: 02/01/2023
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bang.d.nguyen@dot.ca.gov
Organization Phone: (916) 227-7204
General Comments for this Test: Please provide the following results: Bulk specific gravity (oven dry) of coarse aggregate Absorption of coarse aggregate
Test Result Compliance:
Additional Comments When Verified:
Basis for relative density testing Bulk
Specific Gravity 2.705
Absorption 1.3 %

Test 3 of 3

DIME Test ID: 2022-10-20-74-3
Test Method: AASHTO T84-14: Standard Method of Test for Specific Gravity and Absorption of Fine Aggregate (Fine Specific Gravity)
Verified Date: 02/01/2023
Date Tested: 02/01/2023
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bang.d.nguyen@dot.ca.gov
Organization Phone: (916) 227-7204
General Comments for this Test: Please provide the following results: Bulk specific gravity (SSD) of fine aggregate Bulk specific gravity of fine aggregate Apparent specific gravity of fine aggregate Apparent specific gravity of supplemental fines Absorption of fine aggregate
Test Result Compliance:
Additional Comments When Verified:
Bulk specific gravity 2.638
Bulk specific gravity (SSD Basis) 2.695
Apparent specific gravity 2.797
Absorption 2.2 %