DIME - Test Summary

Summary for Test 2022-10-24-55-2

Test performed: CTM 208-September 2011

Project Identifiers	Project ID: 214493 DEA: 07311704 EFIS: 0715000013
DIST-CO-RTE-PM	07-LA-134-0.0/R13.3
Award Date	04/16/2020
Closeout Date	07/09/2024
Work Description	CONCRETE SLAB REPLACEMENT, HMA PAVING, ELECTRICAL AND LANDSCAPE WORK.
Location Description	LOS ANGELES COUNTY IN LOS ANGELES, BURBANK, GLENDALE AND PASADENA FROM ROUTE 101/134 SEPARATION TO JUNCTION OF ROUTE 210/710
QA Service Level	1 (Verified on 04/15/2020)

Sample Taken Date	10/24/2022	Sample Unique Key	55
Will the laboratory/organization for which you are a member perform testing on this material sample?	Yes	Date that the sample was received by the laboratory/organization performing the testing	10/28/2022
Sample type	Department Acceptance	A brief description of the sample	CRM Scrap
The quantity of what the sample constitutes	1 bag	From where was the sample collected	Manufacturer
First name of sampler or witnessed by	Caltrans	Last name of sampler or witnessed by	AAA- QC
Title of sampler		Telephone number of sampler
Laboratory sample identification		Linked DIME Sample ID
The fabricator/manufacturer/facility name	AAA-Irwindale	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name		Bid Item	Not set

Material Type	Crumb Rubber Modifier	CRM Type	Scrap Tire
Crumb Rubber Modifier Mix Number

DIME Sample ID: 2022-10-24-55

DIME Test ID: 2022-10-24-55-2

Testing Lab: CT D08 - Fontana Southern Regional Laboratory

Test Method: CTM 208-September 2011: Method of Test for Apparent Specific Gravity of Fine Aggregates

Test Release Date: 2022-12-19

Input Type: Calculated

Tester's full name: Zaid Hilli

Date of test: 10/28/2022

Specific Gravity: 1.17

General comments (publicly viewable) (Max 1000 characters):

Test was verified on 12/19/2022 ✔