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Sample Record for 2019-09-25-10


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: 2019-09-25-10
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: 09/25/2019
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: 3/4inch HMA-SP RAP WMA PG 64-16
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

Source Identification (SMARA or name of Pit): 91-48-0002::LAKE HERMAN 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: 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 9 of 9

DIME Test ID: 2019-09-25-10-9
Test Method: AASHTO T84-14: Standard Method of Test for Specific Gravity and Absorption of Fine Aggregate (Fine Specific Gravity)
Verified Date: 10/16/2019
Date Tested: 09/25/2019
Submitted By Organization: CT HQ - Hot Mix Asphalt Laboratory
Organization Address: 5900 Folsom Blvd
Test General Comments: Aggregate Quality sample T-84 Bulk Specific gravity of Fine aggregate
Additional Comments When Verified:
Bulk specific gravity 2.591
Bulk specific gravity (SSD Basis) 2.729
Apparent specific gravity 2.883
Absorption 3.9 %