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Sample Record for 2023-10-23-25

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

Project Information

Project ID: 214135 DEA: 09213404 EFIS: 0900000030 QA Service Level: 1
DIST-CO-RTE-PM: 09-INY-395-29.9/41.8
Work Description: ROADWAY EXCAVATION, PLACE HMA (TYPE A), AND ALTERNATIVE PIPE CULVERT.
Location Description: INYO COUNTY NEAR OLANCHA AND CARTAGO FROM 1.4 MILES SOUTH OF LOS ANGELES AQUEDUCT BRIDGE TO 0.2 MILE SOUTH OF ASH CREEK BRIDGE
Contractor Name: FISHER SAND & GRAVEL CO.
Contractor Address: 1302 W DRIVERS WAY, TEPE, AZ. 85284
Resident Engineer: Kris Raber Structure Rep.: Sheila Reyes

Sample Information

DIME Sample ID: 2023-10-23-25
TL Number from the TL Form:
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Department Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/23/2023
Date that the sample was received by the laboratory/organization performing the testing: 10/25/2023
The quantity of what the sample constitutes: 1 Box of Cores
A brief description of the sample: 3/4 HMA Core
From where was the sample collected: Job Site
Laboratory sample identification: Core-R50
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Fisher Sand and Gravel

Material Information

HMA Type: Type A HMA
HMA Grading: 3/4 inch
Lot number:
Sublot number:
HMA Mix Number:

Test Results

Test 1 of 2

DIME Test ID: 2023-10-23-25-1
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: 10/26/2023
Date Tested: 10/26/2023
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
General Comments for this Test: CR-R50
Test Result Compliance: complies
Additional Comments When Verified:
Bulk Specific Gravity 2.364

Test 2 of 2

DIME Test ID: 2023-10-23-25-2
Test Method: AASHTO T269-14: Standard Method of Test for Percent Air Voids in Compacted Dense and Open Asphalt Mixtures (Air Void)
Verified Date: 10/26/2023
Date Tested: 10/26/2023
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
General Comments for this Test: CR-R50
Test Result Compliance: complies
Additional Comments When Verified:
Percent Air Voids 5.2 %