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Sample Record for 2019-01-24-15


Project Information

Project ID: 66667 DEA: JMFPP EFIS: 0019000043 QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for JMF Prequalification Program.
Location Description:
Contractor Name: Contractor Address:
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-01-24-15
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 01/24/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 1
A brief description of the sample: 3/4 Inch HMA-A
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

Source Identification (SMARA or name of Pit): 91-54-0021::DEER CREEK QUARRY
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: Stockpile @ Plant
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:

Test Results

Test Information 10 of 11

DIME Test ID: 2019-01-24-15-12
Test Method: ASTM D4791-10: Standard Test Method for Flat Particles, Elongated Particles, or Flat and Elongated Particles in Coarse Aggregate (Withdrawn 2019) (Flat and Elongated Particles)
Verified Date: 04/10/2019
Date Tested: 01/24/2019
Submitted By Organization: CT HQ - Hot Mix Asphalt Laboratory
Organization Address: 5900 Folsom Blvd
Test General Comments: Aggregate Quality ASTM D-4791
Additional Comments When Verified:
Method A
Determination By Mass
Dimensional ratio used 1:5
Weighted percentage of particles (by mass) that were flat 0 %
Weighted percentage of particles (by mass) that were elongated 0 %
Weighted percentage of particles (by mass) that were both flat and elongated 2 %
Weighted percentage of particles (by mass) that were neither flat nor elongated 98 %