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Testing Report for 2021-05-03-20-12

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

Project Information

Project ID: 211260 DEA: 072159U4 EFIS: 0715000160 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work Description: CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description: LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: George Saker Structure Rep.: Danny Lalonde

Sample Information

DIME Sample ID: 2021-05-03-20
TL Number from the TL Form:
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 05/03/2021
Date that the sample was received by the laboratory/organization performing the testing: 05/10/2021
The quantity of what the sample constitutes: 5 Bags of Combined Aggregate, 2 Bags of RAP
A brief description of the sample: PSUE 3/4" HMA-A-SP R21 0.5% LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0269A-21
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan - Irwindale

Material Information

Source Identification (SMARA or name of Pit): 91-19-0035, 91-19-0016
The fabricator's/manufacturer's product name for the sample: 3/4 HMA-A-SP R21
The fabricator/manufacturer designation for the sample:
The plant number: 220817A IRW SJR
A detailed description of where the material sample was collected: Belt Cut at Vulcan Irwindale Plant
Where the material sample would have been placed if not sampled: Asphalt Paving
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number:

Test Information

DIME Test ID: 2021-05-03-20-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 05/17/2021
Date Tested: 05/12/2021
Submitted By Organization: CT - Southern Regional Laboratory
Organization Address: 13970 Victoria St,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 213-792-4794
General Comments for this Test: Combined Virgin Aggregate Gradation
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Basis for relative density testing Bulk
Specific Gravity 2.694
Absorption 0.9 %