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Sample Record for 2023-08-29-67

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

Project Information

Project ID: 994649 DEA: 070W4204 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-170-R14.5/R20.6
Work Description: SLURRY SEAL AND REPLACE ASPHALT CONCRETE SURFACING.
Location Description: LOS ANGELES COUNTY IN LOS ANGELES FROM JUNCTION ROUTE 134 TO ROUTE 170/5 SEPARATION
Contractor Name: INTERMOUNTAIN SLURRY SEAL, INC.
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2023-08-29-67
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Plant Services
Sample Organization Contact: 562-345-3126
Type of Sample: Department Acceptance
Type of Material: Aggregate
Sample Taken Date: 08/29/2023
Date that the sample was received by the laboratory/organization performing the testing: 09/08/2023
The quantity of what the sample constitutes: 610 tons
A brief description of the sample: 3/4 HMA-A
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA-Irwindale

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-33-0005
The fabricator's/manufacturer's product name for the sample: 3/4 HMA-A
The fabricator/manufacturer designation for the sample: Mix 105793
The plant number: Irwindale
A detailed description of where the material sample was collected: Belt Discharge
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: 105793
Lot number:
Sublot number:
Aggregate Mix Number:

Test Results

Test 1 of 3

DIME Test ID: 2023-08-29-67-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 09/26/2023
Date Tested: 09/08/2023
Submitted By Organization: CT D07 - Plant Services
Organization Address: 13230 East Firestone Boulevard, Suite G,
Organization City: Santa Fe Springs
Organization State: CA
Organization Zipcode: 90670
Organization Email: victor.zengler@dot.ca.gov
Organization Phone: (562) 345-3126
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 99 %
Cumulative percent passing the 1/2 in. sieve 88 %
Cumulative percent passing the 3/8 in. sieve 76 %
Cumulative percent passing the #4 sieve 50 %
Cumulative percent passing the #8 sieve 34 %
Cumulative percent passing the #16 sieve 23 %
Cumulative percent passing the #30 sieve 15 %
Cumulative percent passing the #50 sieve 9 %
Cumulative percent passing the #100 sieve 6 %
Cumulative percent passing the #200 sieve 4.4 %

Test 2 of 3

DIME Test ID: 2023-08-29-67-2
Test Method: AASHTO T11-5: Standard Method of Test for Materials Finer Than 75-μm (No. 200) Sieve in Mineral Aggregates by Washing
Verified Date: 09/26/2023
Date Tested: 09/08/2023
Submitted By Organization: CT D07 - Plant Services
Organization Address: 13230 East Firestone Boulevard, Suite G,
Organization City: Santa Fe Springs
Organization State: CA
Organization Zipcode: 90670
Organization Email: victor.zengler@dot.ca.gov
Organization Phone: (562) 345-3126
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
Which test procedure is being used Method A
Percent of sample passing the #200 sieve (by mass) 8.8 %

Test 3 of 3

DIME Test ID: 2023-08-29-67-3
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: 09/26/2023
Date Tested: 09/08/2023
Submitted By Organization: CT D07 - Plant Services
Organization Address: 13230 East Firestone Boulevard, Suite G,
Organization City: Santa Fe Springs
Organization State: CA
Organization Zipcode: 90670
Organization Email: victor.zengler@dot.ca.gov
Organization Phone: (562) 345-3126
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Sand Equivalent 62