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Sample Record for 2020-10-13-24

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

Project Information

Project ID: 214885 DEA: 080K1234 EFIS: 0815000242 QA Service Level: 1
DIST-CO-RTE-PM: 08---
Work Description:
Location Description:
Contractor Name: SULLY-MILLER CONTRACTING COMPANY
Contractor Address: 135 S STATE COLLEGE BLVD #400, BREA CA 92821
Resident Engineer: Taghreed Al-Khateeb Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2020-10-13-24
TL Number from the TL Form: Blue Diamond
Sample Submitted By Organization: CT D08 - Hesperia Field Testing Laboratory
Sample Organization Contact: (951) 840-8242
Type of Sample: Acceptance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/13/2020
Date that the sample was received by the laboratory/organization performing the testing: 10/08/2020
The quantity of what the sample constitutes: 2 box, 3 cores
A brief description of the sample: Rte 15 sta 03+90, sta 15+00, sta 29+00
From where was the sample collected: Job Site
Laboratory sample identification: 40-A, 40-B, 40-C
Structure unique identifier:
Structure name: I 15 N Sidewinder Rd
The fabricator/manufacturer/facility name: OHL, Sully Miller

Material Information

HMA Type: RHMA-G
HMA Grading: 3/4 inch
Lot number:
Sublot number:
HMA Mix Number:

Test Results

Test 1 of 2

DIME Test ID: 2020-10-13-24-1
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Verified Date: 11/10/2020
Date Tested: 10/22/2020
Submitted By Organization: CT D08 - Hesperia Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Number of tests 3
What is the unit of measurement for theoretical density? US Units
Mass Determination Air
Specific Gravity for Sample 1 95.600
Specific Gravity for Sample 2 95.100
Specific Gravity for Sample 3 96.000
Average Specific Gravity 95.600
Theoretical maximum density at 25°C (77°F) no data

Test 2 of 2

DIME Test ID: 2020-10-13-24-2
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Submitted By Organization: CT D08 - Hesperia Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
Data has not been verified.