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: 2021-06-01-14

TL Number from the TL Form:

Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory

Sample Organization Contact: 213-792-4794

Type of Sample: Acceptance

Type of Material: Aggregate

Sample Taken Date: 06/01/2021

Date that the sample was received by the laboratory/organization performing the testing: 06/04/2021

The quantity of what the sample constitutes: 6 Bags of Combined Aggregate

A brief description of the sample: PSUE 3/4" RHMA-G-SP 0.5% LAS

From where was the sample collected: Manufacturer

Laboratory sample identification: 0332G-21

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: California Commercial Asphalt - Lake Elsinore

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-33-0098

The fabricator's/manufacturer's product name for the sample: 3/4 RHMA-G-SP

The fabricator/manufacturer designation for the sample:

The plant number: 53418180

A detailed description of where the material sample was collected: Belt Cut at California Commercial Asphalt Lake Elsinore 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:

Aggregate Mix Number:

Test Results

Test 1 of 2

DIME Test ID: 2021-06-01-14-1

Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)

Verified Date: 06/08/2021

Date Tested: 06/07/2021

Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory

Organization Address: 13970 Victoria Street,

Organization City: Fontana

Organization State: CA

Organization Zipcode: 92336

Organization Email: jose.guzman@dot.ca.gov

Organization Phone: 9098293029

General Comments for this Test: Combined Virgin Aggregate Gradation

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	97 %
Cumulative percent passing the 1/2 in. sieve	83 %
Cumulative percent passing the 3/8 in. sieve	69 %
Cumulative percent passing the #4 sieve	35 %
Cumulative percent passing the #8 sieve	16 %
Cumulative percent passing the #16 sieve	10 %
Cumulative percent passing the #30 sieve	6 %
Cumulative percent passing the #50 sieve	5 %
Cumulative percent passing the #100 sieve	3 %
Cumulative percent passing the #200 sieve	2.6 %

Test 2 of 2

DIME Test ID: 2021-06-01-14-5

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)