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Testing Report for 2021-06-03-15-7

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

Project Information

DEA: 081H4904
EFIS: 0817000059
Project ID: 215494
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-18-31.9/38.5
Work Description: COLD PLANE AC PAVEMENT AND OVERLAY WITH HMA (TYPE A).
Location Description: SAN BERNARDINO COUNTY FROM 0.1 MILE EAST OF HILLTOP CONNECTOR TO 0.5 MILE EAST OF SIBERIA CREEK TRAIL
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Nhan Nguyen
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-06-03-15
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: 6/3/2021
Date that the sample was received by the laboratory/organization performing the testing: 6/7/2021
The quantity of what the sample constitutes: 5 Bags of Combined Aggregate, 3 Bags of RAP
A brief description of the sample: 3/4" HMA-A-SP R12, 0.75% LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0333A-21
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Matich-Lytle Creek

Material Information

Source Identification (SMARA or name of Pit): 91-36-0040
The fabricator's/manufacturer's product name for the sample: 3/4 HMA-A-SP R12
The fabricator/manufacturer designation for the sample:
The plant number: LHP 62D
A detailed description of where the material sample was collected: Belt Cut at Matich Lytle Creek 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: 2021-06-03-15-7
Test Method: AASHTO T335-09r13: Standard Method of Test for Determining the Percentage of Fracture in Coarse Aggregate (Percent of Crushed Particles)
Date Tested: 6/9/2021
Verified Date: 6/24/2021
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:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Method: 1 - Combined Fracture Determination
Aggregate Size and Fracture Type: Coarse 1 and 2 Faced and Fine 1 Faced
Percentage of fractured, coarse, 2 faced particles tested: 99 %
Percentage of fractured, coarse, 1 faced particles tested: 100 %
Percentage of fractured, fine, 1 faced particles tested: 100 %