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Sample Record for 2023-11-01-73

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

Project Information

Project ID: 994821 DEA: 080J2404 EFIS: 0822000124 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-142-3.5/R3.9
Work Description: HMA (TYPE A), RUBBERIZED HMA (GAP GRADED), CL 2 AB, RDWY EXCAVATION.
Location Description: SAN BERNARDINO COUNTY IN CHINO HILLS FROM 0.5 MILE NORTH OF FELDSPAR DRIVE TO CHINO HILLS PARKWAY
Contractor Name: POWELL CONSTRUCTORS INC
Contractor Address: 644 Pedley Rd., Riverside. CA
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2023-11-01-73
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: 9512323690
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 11/01/2023
Date that the sample was received by the laboratory/organization performing the testing: 11/07/2023
The quantity of what the sample constitutes: 1 box, 4 cores
A brief description of the sample: RHMA-G-SP 3/4"
From where was the sample collected: Job Site
Laboratory sample identification: 1C,2C,3C,4A
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA Corona

Material Information

HMA Type: RHMA-G
HMA Grading: 3/4 inch
Lot number:
Sublot number:
HMA Mix Number: 106835

Test Results

Test 1 of 3

DIME Test ID: 2023-11-01-73-1
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Verified Date: 11/15/2023
Date Tested: 11/13/2023
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of tests 1
What is the unit of measurement for theoretical density? US Units
Mass Determination Air
Specific Gravity for Sample 1 2.447
Theoretical maximum density at 25°C (77°F) 152.3 lb/ft^3

Test 2 of 3

DIME Test ID: 2023-11-01-73-2
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)
Verified Date: 11/15/2023
Date Tested: 11/13/2023
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test: 1C, 2C, 3C
Test Result Compliance: complies
Additional Comments When Verified:
Bulk Specific Gravity 2.286
Bulk Specific Gravity 2 2.274
Bulk Specific Gravity 3 2.326
Average Bulk Specific Gravity 2.29

Test 3 of 3

DIME Test ID: 2023-11-01-73-3
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: 11/15/2023
Date Tested: 11/13/2023
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test: 4A
Test Result Compliance: complies
Additional Comments When Verified:
Bulk Specific Gravity 2.275