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Sample Record for 2021-01-13-12

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

Project Information

Project ID: 213707 DEA: 081C38U4 EFIS: 0817000196 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-10-6.7/R25.1
Work Description: Remove concrete pavement and base, and place HMA and JPCP
Location Description: ROUTE 10/60 SEPARATION IN BEAUMONT TO ROUTE 10/111 SEPARATION NEAR CABAZON.
Contractor Name: Coffman Specialties
Contractor Address: 9685 Via Excelencia, San Diego, CA 92126
Resident Engineer: Elvira Lenart Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-01-13-12
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: 9512323690
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 01/13/2021
Date that the sample was received by the laboratory/organization performing the testing: 01/14/2021
The quantity of what the sample constitutes: 4 Bags
A brief description of the sample: HMA-A 3/4" R24
From where was the sample collected: Manufacturer
Laboratory sample identification: 1
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: California Commercial Asphalt - Coachella

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-33-0084
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: belt an chute
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: 43417615
Lot number:
Sublot number:
Aggregate Mix Number:

Test Results

Test 1 of 2

DIME Test ID: 2021-01-13-12-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 01/15/2021
Date Tested: 01/14/2021
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
What type of gradation is being tested? Combined Gradation
Cumulative percent passing the 2 in. sieve 100 %
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 %
Cumulative percent passing the 1/2 in. sieve 83 %
Cumulative percent passing the 3/8 in. sieve 71 %
Cumulative percent passing the #4 sieve 44 %
Cumulative percent passing the #8 sieve 34 %
Cumulative percent passing the #16 sieve 25 %
Cumulative percent passing the #30 sieve 18 %
Cumulative percent passing the #50 sieve 12 %
Cumulative percent passing the #100 sieve 7 %
Cumulative percent passing the #200 sieve 4.2 %

Test 2 of 2

DIME Test ID: 2021-01-13-12-2
Test Method: AASHTO T176-08: Standard Method of Test for Plastic Fines in Graded Aggregates and Soils by Use of the Sand Equivalent Test (Sand Equivalent)
Verified Date: 01/15/2021
Date Tested: 01/14/2021
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Sand Equivalent 87