Project Information

Project ID: 993508 DEA: 070W1104 EFIS: 0721000059 QA Service Level: 1

DIST-CO-RTE-PM: 07-LA-210-R35.9/R52.2

Work Description: COLD PLANE OVERLAY, INDIVIDUAL REPLACEMENT SLAB AND TRAFFIC STRIPING.

Location Description: LOS ANGELES COUNTY FROM HIGHLAND AVENUE UNDERCROSSING IN DUARTE TO SAN ANTONIO WASH BRIDGE IN CLAREMONT.

Contractor Name: Pavement Coatings

Contractor Address: 10240 San Sevaine Way, Jurupa Valley, CA 91752

Resident Engineer: Moe Izadpanah Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2023-02-07-42

TL Number from the TL Form:

Sample Submitted By Organization: CT D07 - Plant Services

Sample Organization Contact: 562-345-3126

Type of Sample: Acceptance

Type of Material: Aggregate

Sample Taken Date: 02/07/2023

Date that the sample was received by the laboratory/organization performing the testing: 02/07/2023

The quantity of what the sample constitutes: 1 bag

A brief description of the sample: three quarter inch HMA Type A aggregate

From where was the sample collected: Fabricator

Laboratory sample identification:

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: Vulcan Irwindale

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-19-0035

The fabricator's/manufacturer's product name for the sample: 3/4 HMA Aggregate

The fabricator/manufacturer designation for the sample: Drum Plant

The plant number:

A detailed description of where the material sample was collected: Conveyor Belt at Plant

Where the material sample would have been placed if not sampled: HMA Mat

Primary Aggregate Nominal Size: 3/4 inch

The concrete mix design number: 220831 A

Lot number:

Sublot number:

Aggregate Mix Number:

Test Results

Test 1 of 2

DIME Test ID: 2023-02-07-42-1

Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)

Verified Date: 03/02/2023

Date Tested: 02/07/2023

Submitted By Organization: CT D07 - Plant Services

Organization Address: 13230 East Firestone Boulevard, Suite G,

Organization City: Santa Fe Springs

Organization State: CA

Organization Zipcode: 90670

Organization Email: victor.zengler@dot.ca.gov

Organization Phone: (562) 345-3126

General Comments for this Test:

Test Result Compliance: complies

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	98 %
Cumulative percent passing the 1/2 in. sieve	79 %
Cumulative percent passing the 3/8 in. sieve	68 %
Cumulative percent passing the #4 sieve	46 %
Cumulative percent passing the #8 sieve	34 %
Cumulative percent passing the #16 sieve	24 %
Cumulative percent passing the #30 sieve	16 %
Cumulative percent passing the #50 sieve	10 %
Cumulative percent passing the #100 sieve	6 %
Cumulative percent passing the #200 sieve	3.7 %

Test 2 of 2

DIME Test ID: 2023-02-07-42-2

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)