Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215109 DEA: 081C8504 EFIS: 0813000047
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-74-0.0/5.8
Work Description: ROADWAY EXCAVATION, HOT MIX ASPHALT, AND STRUCTURAL SHOTCRETE WALLS.
Location Description: RIVERSIDE COUNTY NEAR LAKE ELSINORE FROM ORANGE COUNTY LINE TO MONTE VISTA STREET
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 38000 MONROE STREET, INDIO, CA 92203
Resident Engineer: Osama Abdalla Structure Rep.: Ryan Kash (Reports)
DIME Sample ID: 2023-09-27-75
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Barstow Field Laboratory 1
Sample Organization Contact: (760) 252-9216
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 09/27/2023
Date that the sample was received by the laboratory/organization performing the testing: 10/03/2023
The quantity of what the sample constitutes: 1 CORE
A brief description of the sample: 3/4" HMA A
From where was the sample collected: Manufacturer
Laboratory sample identification: L2 SL19 NO 19A
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Diamond LakeElsino
DIME Test ID: 2023-09-27-75-1
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: 10/20/2023
Date Tested: 10/11/2023
Submitted By Organization: CT D08 - Barstow Field Laboratory 1
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test: REL COMPACT 97.7%
Test Result Compliance: complies
Additional Comments When Verified:
Bulk Specific Gravity
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2.425
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