Project Information

Project ID: 214337 DEA: 080E33U4 EFIS: 0817000075 QA Service Level: 1

DIST-CO-RTE-PM: 08-SBD-115-R7.3/R10.0

Work Description: ADD WB AUX & EB DECEL LANES, WIDEN I15 SW CONNECT,RAMPS/BRDG

Location Description: SAN BERNARDINO COUNTY IN ONTARIO FROM 0.2 MILE WEST OF CUCAMONGA CREEK BRIDGE TO MILLIKEN AVENUE

Contractor Name: Ames Construction

Contractor Address: 391 North Main Street, Suite 302, Corona, CA 92880

Resident Engineer: Denise Sostrom Structure Rep.: Matt Bruce

Sample Information

DIME Sample ID: 2023-11-29-18

TL Number from the TL Form:

Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory

Sample Organization Contact: 9512323690

Type of Sample: Department Acceptance

Type of Material: Aggregate

Sample Taken Date: 11/29/2023

Date that the sample was received by the laboratory/organization performing the testing: 11/30/2023

The quantity of what the sample constitutes: 1 Bags of Aggregate

A brief description of the sample: 3/4" RHMA-G

From where was the sample collected: Manufacturer

Laboratory sample identification:

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 AAA - Corona

Where the material sample would have been placed if not sampled:

Primary Aggregate Nominal Size: 3/4 inch

The concrete mix design number:

Lot number:

Sublot number:

Aggregate Mix Number: 106835

Test Results

Test 1 of 2

DIME Test ID: 2023-11-29-18-1

Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)

Verified Date: 12/05/2023

Date Tested: 12/04/2023

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: #1

Test Result Compliance: complies

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	93 %
Cumulative percent passing the 1/2 in. sieve	77 %
Cumulative percent passing the 3/8 in. sieve	62 %
Cumulative percent passing the #4 sieve	36 %
Cumulative percent passing the #8 sieve	20 %
Cumulative percent passing the #16 sieve	16 %
Cumulative percent passing the #30 sieve	10 %
Cumulative percent passing the #50 sieve	6 %
Cumulative percent passing the #100 sieve	3 %
Cumulative percent passing the #200 sieve	2.4 %

Test 2 of 2

DIME Test ID: 2023-11-29-18-2

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)