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Sample Record for 2023-07-07-1

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

Project Information

Project ID: 215744 DEA: 033H93U4 EFIS: 0321000091 QA Service Level: 1
DIST-CO-RTE-PM: 03-YUB,BUT-70-25.5/25.8,0.0/3.8
Work Description: WIDEN ROADWAY & SHOULDER, ADD TURN LANES & CONSTRUCT BRIDGE.
Location Description: YUBA AND BUTTE COUNTIES ABOUT 11 MILES NORTH OF MARYSVILLE FROM 0.8 MILE NORTH OF CHANDLER ROAD TO 0.2 MILE SOUTH OF EAST GRIDLEY ROAD
Contractor Name: Teichert Construction & MCM JV
Contractor Address: 4401 Duluth Ave, Rocklin, CA 95766
Resident Engineer: Anthony Granados Structure Rep.: Matt Crete

Sample Information

DIME Sample ID: 2023-07-07-1
TL Number from the TL Form: 779497
Sample Submitted By Organization: CT D03 - Chico Field Laboratory
Sample Organization Contact: (916) 799-4305
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 07/07/2023
Date that the sample was received by the laboratory/organization performing the testing: 07/07/2023
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4 HMA-A W/15% RAP
From where was the sample collected: Supplier
Laboratory sample identification: L6S2
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Materials Hallwood

Material Information

HMA Type: Type A HMA
HMA Grading: 3/4 inch
Lot number: 6
Sublot number: 2
HMA Mix Number: 22008
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2023-07-07-1-1
Test Method: AASHTO T209-22: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Submitted By Organization: CT D03 - Chico Field Laboratory
Organization Address: 2707 Notre Dame Boulevard,
Organization City: Chico
Organization State: CA
Organization Zipcode: 95928
Organization Email: bmckeehan@ghirardelliassoc.com
Organization Phone: (916) 799-4305
Data has not been verified.

Test 2 of 2

DIME Test ID: 2023-07-07-1-2
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)
Submitted By Organization: CT D03 - Chico Field Laboratory
Organization Address: 2707 Notre Dame Boulevard,
Organization City: Chico
Organization State: CA
Organization Zipcode: 95928
Organization Email: bmckeehan@ghirardelliassoc.com
Organization Phone: (916) 799-4305
Data has not been verified.