Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993631 DEA: 120S8904 EFIS: 1221000058
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-1-R0.1/R1.0
Work Description: COLD PLANE AC PAVEMENT AND PLACE RHMA.
Location Description: ORANGE COUNTY IN DANA POINT AND SAN JUAN CAPISTRANO FROM ROUTE 5/1 SEPARATION TO SAN JUAN CREEK BRIDGE
Contractor Name: RJ NOBLE
Contractor Address: Unknown
Resident Engineer: Irvin Nguyen Structure Rep.: Unknown
DIME Sample ID: 2023-05-22-94
TL Number from the TL Form:
Sample Submitted By Organization: CT D12 - Huntington Beach Field Laboratory
Sample Organization Contact: 9492798846
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 05/22/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/23/2023
The quantity of what the sample constitutes: RHMA cores
A brief description of the sample: 1/2 RHMAG
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RJ Noble Orange
DIME Test ID: 2023-05-22-94-1
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: 06/23/2023
Date Tested: 06/16/2023
Submitted By Organization: CT D12 - Huntington Beach Field Laboratory
Organization Address: 19601 Beach Boulevard,
Organization City: Huntington Beach
Organization State: CA
Organization Zipcode: 92648
Organization Email: frank.mai@dot.ca.gov
Organization Phone: (949) 279-8846
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
|
Bulk Specific Gravity
|
2.242
|
