Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
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
DIME Sample ID: 2023-05-24-63
TL Number from the TL Form: na
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Department Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 05/24/2023
Date that the sample was received by the laboratory/organization performing the testing: 06/08/2023
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4' rhma - a220831 sva sjr
From where was the sample collected: Job Site
Laboratory sample identification: 23-177
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA Irwindale
DIME Test ID: 2023-05-24-63-1
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: 06/14/2023
Date Tested: 06/12/2023
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 817-0387
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Bulk Specific Gravity
|
2.307
|
Bulk Specific Gravity 2
|
2.284
|
Average Bulk Specific Gravity
|
2.295
|