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Sample Record for 2020-03-02-1

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

Project Information

Project ID: 9999 DEA: 00000000 EFIS: 0000000000 COOP: 99999333399 MINOR: 333333 Permit Numbers: 555555 0400NRT0000 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: YYZ
Contractor Address: 1234 address, Sacramento, CA 95824
Resident Engineer: RE_first RE_last Structure Rep.: SR_First SR_Last

Sample Information

DIME Sample ID: 2020-03-02-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Sample Organization Contact: (562) 500-5861
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 03/02/2020
Date that the sample was received by the laboratory/organization performing the testing: 03/06/2022
The quantity of what the sample constitutes: 1
A brief description of the sample: 12
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: aaa

Material Information

Source Identification (SMARA, name of Pit or Job Site): 12323123
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: testing site
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:

Test Results

Test 1 of 3

DIME Test ID: 2020-03-02-1-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 03/02/2020
Date Tested: 03/01/2020
Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance:
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 98.8 %
Cumulative percent passing the 1/2 in. sieve 89.6 %
Cumulative percent passing the 3/8 in. sieve 75.4 %
Cumulative percent passing the 1/4 in. sieve 100 %
Cumulative percent passing the #4 sieve 51.6 %
Cumulative percent passing the #8 sieve 39.7 %
Cumulative percent passing the #16 sieve 29.5 %
Cumulative percent passing the #30 sieve 21.4 %
Cumulative percent passing the #50 sieve 12.8 %
Cumulative percent passing the #100 sieve 6.4 %
Cumulative percent passing the #200 sieve 3.28 %

Test 2 of 3

DIME Test ID: 2020-03-02-1-2
Test Method: AASHTO T84-14: Standard Method of Test for Specific Gravity and Absorption of Fine Aggregate (Fine Specific Gravity)
Verified Date: 03/02/2020
Date Tested: 03/01/2020
Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Bulk specific gravity 2.500
Bulk specific gravity (SSD Basis) 2.560
Apparent specific gravity 2.660
Absorption 2.4 %

Test 3 of 3

DIME Test ID: 2020-03-02-1-3
Test Method: AASHTO T85-13: Standard Method of Test for Specific Gravity and Absorption of Coarse Aggregate (Coarse Specific Gravity)
Verified Date: 03/02/2020
Date Tested: 03/01/2020
Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Basis for relative density testing Bulk
Specific Gravity 2.524
Absorption 2.2 %