Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212737 DEA: 060S8304 EFIS: 0615000046
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-5-44.4-45.4
Work Description: TUMEY GULCH ABUTMENT REHAB BR# 42-0246L/R.
Location Description: IN FRESNO COUNTY AT TUMEY GULCH.
Contractor Name: Bruce Shumacher
Contractor Address: 2716 S Granite Ct, Fresno, CA 93706
Resident Engineer: Cary Cruz Structure Rep.: Ben Holton
DIME Sample ID: 2023-04-21-1
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Millbrook Field Laboratory
Sample Organization Contact: (559) 417-5341
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 04/21/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/21/2023
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4” HMA A R25
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Colinga
Source Identification (SMARA, name of Pit or Job Site): 91-10-0005
The fabricator's/manufacturer's product name for the sample: 1466s
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: 22-J-023b
Lot number: 3
Sublot number: 7
Aggregate Mix Number:
DIME Test ID: 2023-04-21-1-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Submitted By Organization: CT D06 - Millbrook Field Laboratory
Organization Address: 3240 North Millbrook Avenue,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93726
Organization Email: tomas.silva@dot.ca.gov
Organization Phone: (559) 417-5341
Data has not been verified.
DIME Test ID: 2023-04-21-1-2
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)
Verified Date: 04/26/2023
Date Tested: 04/25/2023
Submitted By Organization: CT D06 - Millbrook Field Laboratory
Organization Address: 3240 North Millbrook Avenue,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93726
Organization Email: tomas.silva@dot.ca.gov
Organization Phone: (559) 417-5341
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
