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Sample Record for 2023-06-05-61

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Project Information

Project ID: 993547 DEA: 081G7204 EFIS: 0816000057 COOP: 081666 Permit Numbers: 0819AOP0691 QA Service Level: 2
DIST-CO-RTE-PM: 08---
Work Description: METS have reviewed the (Source Inspection Quality Management Plan) SIQMP, Rev1 submitted on behalf of The city of Lake Elsinore. We are glad to inform you that it significantly complies.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Mike Mohammadi Structure Rep.: Shukri Abouazra

Sample Information

DIME Sample ID: 2023-06-05-61
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 06/05/2023
Date that the sample was received by the laboratory/organization performing the testing: 07/21/2023
The quantity of what the sample constitutes: 4 Bags Of Comb. Agg., 1 Bag each Of Scrap & Crum Rubber
A brief description of the sample: JMF-1/2" RHMA-G-SP 1.0% LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0376G-23
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: All American Asphalt- Corona

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-33-0005
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Belt Cut at All American Corona Plant
Where the material sample would have been placed if not sampled: Asphalt Paving
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number: 106836
Lot number:
Sublot number:
Aggregate Mix Number:
Test results on following page(s): 8

Test Results

Test 1 of 8

DIME Test ID: 2023-06-05-61-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 10/04/2023
Date Tested: 07/26/2023
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test: Combined L.T. Aggregate Gradation
Test Result Compliance:
Additional Comments When Verified:
What type of gradation is being tested? Combined Gradation
Cumulative percent passing the 2 in. sieve 100 %
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 95 %
Cumulative percent passing the 3/8 in. sieve 81 %
Cumulative percent passing the #4 sieve 36 %
Cumulative percent passing the #8 sieve 18 %
Cumulative percent passing the #16 sieve 11 %
Cumulative percent passing the #30 sieve 8 %
Cumulative percent passing the #50 sieve 5 %
Cumulative percent passing the #100 sieve 4 %
Cumulative percent passing the #200 sieve 3 %

Test 2 of 8

DIME Test ID: 2023-06-05-61-2
Test Method: AASHTO T84-14: Standard Method of Test for Specific Gravity and Absorption of Fine Aggregate (Fine Specific Gravity)
Verified Date: 10/04/2023
Date Tested: 07/26/2023
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Bulk specific gravity 2.693
Bulk specific gravity (SSD Basis) 2.716
Apparent specific gravity 2.756
Absorption 0.8 %

Test 3 of 8

DIME Test ID: 2023-06-05-61-3
Test Method: AASHTO T85-13: Standard Method of Test for Specific Gravity and Absorption of Coarse Aggregate (Coarse Specific Gravity)
Verified Date: 10/04/2023
Date Tested: 07/26/2023
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Basis for relative density testing Bulk
Specific Gravity 2.696
Absorption 0.8 %

Test 4 of 8

DIME Test ID: 2023-06-05-61-4
Test Method: AASHTO T96-02r10: Standard Method of Test for Resistance to Degradation of Small-Size Coarse Aggregate by Abrasion and Impact in the Los Angeles Machine (Los Angeles Rattler)
Verified Date: 10/04/2023
Date Tested: 07/27/2023
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Grading designation C
Mass of sample on No.12 sieve (after 500 revolutions) 3862 grams
Percent loss after 100 revolutions 6 %
Percent loss after 500 revolutions 23 %

Test 5 of 8

DIME Test ID: 2023-06-05-61-5
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: 10/04/2023
Date Tested: 07/26/2023
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sand Equivalent 77

Test 6 of 8

DIME Test ID: 2023-06-05-61-6
Test Method: AASHTO T304-11: Standard Method of Test for Uncompacted Void Content of Fine Aggregate (Fine of Crushed Particles)
Verified Date: 10/04/2023
Date Tested: 08/01/2023
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
What test method is performed? Method A
Bulk dry specific gravity 2.693
Average uncompacted voids 47.3 %

Test 7 of 8

DIME Test ID: 2023-06-05-61-7
Test Method: AASHTO T335-09r13: Standard Method of Test for Determining the Percentage of Fracture in Coarse Aggregate (Percent of Crushed Particles)
Verified Date: 10/04/2023
Date Tested: 08/01/2023
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Method 1 - Combined Fracture Determination
Aggregate Size and Fracture Type Coarse 1 and 2 Faced and Fine 1 Faced
Percentage of fractured, coarse, 2 faced particles tested 100 %
Percentage of fractured, coarse, 1 faced particles tested 100 %
Percentage of fractured, fine, 1 faced particles tested 100 %

Test 8 of 8

DIME Test ID: 2023-06-05-61-8
Test Method: ASTM D4791-10: Standard Test Method for Flat Particles, Elongated Particles, or Flat and Elongated Particles in Coarse Aggregate (Withdrawn 2019) (Flat and Elongated Particles)
Verified Date: 10/04/2023
Date Tested: 08/01/2023
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Method B
Determination By Mass
Dimensional ratio used 5:1
Weighted percentage of particles (by mass) that were flat and elongated 0 %
Weighted percentage of particles (by mass) that were not flat and elongated 100 %