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Sample Record for 2023-03-24-19

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

Project Information

Project ID: 993301 DEA: 060U2804 EFIS: 0615000293 QA Service Level: 1
DIST-CO-RTE-PM: 06-TUL-245-1.4,4.2
Work Description: PRECAST PRESTRESSED CONCRETE BOX GIRDER AND SLAB, BRIDGE REMOVAL.
Location Description: TULARE COUNTY NEAR WOODLAKE AT YOKOHL CREEK BRIDGE AND AT KAWEAH RIVER BRIDGE
Contractor Name: MCM Construction
Contractor Address: PO Box 620, North Highlands, Ca 95660
Resident Engineer: Mike Garrett Structure Rep.: Benajamin Holton

Sample Information

DIME Sample ID: 2023-03-24-19
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Visalia Field Laboratory
Sample Organization Contact: (559) 341-4165
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 03/24/2023
Date that the sample was received by the laboratory/organization performing the testing: 03/24/2023
The quantity of what the sample constitutes: 147 tons
A brief description of the sample: HMA 3/4" PG70-10 22-J-026
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name: Kaweah- Yokohl Bridges Wood Land
The fabricator/manufacturer/facility name: Porterville Asphalt PAI

Material Information

Source Identification (SMARA, name of Pit or Job Site): Unknown
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: Conveyor Belt
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number: 1
Sublot number: 3
Aggregate Mix Number: SL3
Test results on following page(s): 4

Test Results

Test 1 of 4

DIME Test ID: 2023-03-24-19-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 03/29/2023
Date Tested: 03/24/2023
Submitted By Organization: CT D06 - Visalia Field Laboratory
Organization Address: 8530 West Roosevelt Avenue,
Organization City: Visalia
Organization State: CA
Organization Zipcode: 93291
Organization Email: shoaib.ahmed@dot.ca.gov
Organization Phone: (559) 341-4165
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
What type of gradation is being tested? Combined Gradation
Cumulative percent passing the 2 in. sieve 100 %
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 99 %
Cumulative percent passing the 1/2 in. sieve 74 %
Cumulative percent passing the 3/8 in. sieve 65 %
Cumulative percent passing the #4 sieve 55 %
Cumulative percent passing the #8 sieve 34 %
Cumulative percent passing the #16 sieve 21 %
Cumulative percent passing the #30 sieve 14 %
Cumulative percent passing the #50 sieve 9 %
Cumulative percent passing the #100 sieve 7 %
Cumulative percent passing the #200 sieve 5.2 %

Test 2 of 4

DIME Test ID: 2023-03-24-19-2
Test Method: AASHTO T210-15: Standard Method of Test for Aggregate Durability Index (Durability Index)
Verified Date: 03/29/2023
Date Tested: 03/24/2023
Submitted By Organization: CT D06 - Visalia Field Laboratory
Organization Address: 8530 West Roosevelt Avenue,
Organization City: Visalia
Organization State: CA
Organization Zipcode: 93291
Organization Email: shoaib.ahmed@dot.ca.gov
Organization Phone: (559) 341-4165
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Which test procedure(s) is/are used? Procedure A
Was strict temperature control maintained? No
What type of water was used? Distilled
Durability Index (coarse) 80

Test 3 of 4

DIME Test ID: 2023-03-24-19-3
Test Method: AASHTO T210-15: Standard Method of Test for Aggregate Durability Index (Durability Index)
Verified Date: 03/29/2023
Date Tested: 03/24/2023
Submitted By Organization: CT D06 - Visalia Field Laboratory
Organization Address: 8530 West Roosevelt Avenue,
Organization City: Visalia
Organization State: CA
Organization Zipcode: 93291
Organization Email: shoaib.ahmed@dot.ca.gov
Organization Phone: (559) 341-4165
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Which test procedure(s) is/are used? Procedure C
Was strict temperature control maintained? No
What type of water was used? Distilled
Durability Index (coarse) 65

Test 4 of 4

DIME Test ID: 2023-03-24-19-4
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)
Verified Date: 03/29/2023
Date Tested: 03/24/2023
Submitted By Organization: CT D06 - Visalia Field Laboratory
Organization Address: 8530 West Roosevelt Avenue,
Organization City: Visalia
Organization State: CA
Organization Zipcode: 93291
Organization Email: shoaib.ahmed@dot.ca.gov
Organization Phone: (559) 341-4165
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Sand Equivalent 65