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Testing Report for 2021-01-04-9-2

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

Project Information

DEA: 081C38U4
EFIS: 0817000196
Project ID: 213707
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: Unknown
Contractor Address: Unknown
Resident Engineer: Elvira Lenart
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-01-04-9
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: (951) 840-8328
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 1/4/2021
Date that the sample was received by the laboratory/organization performing the testing: 1/11/2021
The quantity of what the sample constitutes: 2 box, 3 cores
A brief description of the sample: HMA-A 3/4" PG 58-34M
From where was the sample collected: Manufacturer
Laboratory sample identification: 1A109, 1B109, 1C109
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CCA-Coachella

Material Information

HMA Type: Type A HMA
HMA Grading: 3/4 inch
Lot number: Unknown
Sublot number: Unknown

Test Information

DIME Test ID: 2021-01-04-9-2
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Date Tested: 1/12/2021
Verified Date: 1/15/2021
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria St,
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:
Additional Comments When Verified :

Submitted Test Results

Number of tests: 1
Mass Determination: Water
Specific Gravity for Sample 1: 2.498