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Sample Record for 2023-05-22-90

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Project Information

Project ID: 212496 DEA: 024E4504 EFIS: 0200020286 QA Service Level: 1
DIST-CO-RTE-PM: 02-LAS,MOD-139,299-VAR
Work Description: PLACE HMA, REPLACE DRAINAGE, CULVERT, ELECTRICAL AND LIGHTING SYSTEMS.
Location Description: LASSEN AND MODOC COUNTIES ON ROUTE 139 AT 0.1 MILE NORTH OF LASSEN COUNTY LINE AND ON ROUTE 299 AT VARIOUS LOCATONS FROM 0.4 MILE WEST OF BOYD HILL LOOKOUT ROAD TO 0.6 MILE EAST OF COUNTY ROAD 87
Contractor Name: PAR ELECTRICAL CONTRACTORS INC
Contractor Address: 1465 WEST FOURTH STREET, RENO, NV 89503
Resident Engineer: Mike Zdenek Structure Rep.: Chris Brace

Sample Information

DIME Sample ID: 2023-05-22-90
TL Number from the TL Form: 857930
Sample Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Sample Organization Contact: (530) 225-3194
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 05/22/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/22/2023
The quantity of what the sample constitutes: JMF 23-03-S01
A brief description of the sample: 2 bags of Untreated Washed Dust Sized Virgin Aggregate
From where was the sample collected: Manufacturer
Laboratory sample identification: D79242D
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Hat Creek Construction and Materials - Shaw Pit Facility - Lookout, CA

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-25-0008::Shaw Pit - Lookout, CA
The fabricator's/manufacturer's product name for the sample: Washed Dust
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Stockpile at Plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/8 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2023-05-22-90-1
Test Method: AASHTO T104-99r16: Standard Method of Test for Soundness of Aggregate by Use of Sodium Sulfate or Magnesium Sulfate (Soundness)
Verified Date: 07/18/2023
Date Tested: 07/18/2023
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:
Size of aggregate being tested Fine Aggregate
What type of solution was used? Sodium sulfate
What was the condition of the solution? Previously used
Number of immersion cycles performed 5
Fine weighted average loss 10.4 %

Test 2 of 2

DIME Test ID: 2023-05-22-90-2
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 06/20/2023
Date Tested: 05/25/2023
Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Organization Address: 1657 Riverside Drive,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: 530-225-3194
General Comments for this Test:
Test Result Compliance: not applicable
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 100 %
Cumulative percent passing the 3/8 in. sieve 100 %
Cumulative percent passing the #4 sieve 100 %
Cumulative percent passing the #8 sieve 49 %
Cumulative percent passing the #16 sieve 28 %
Cumulative percent passing the #30 sieve 15 %
Cumulative percent passing the #50 sieve 8 %
Cumulative percent passing the #100 sieve 4 %
Cumulative percent passing the #200 sieve 2.7 %