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Testing Report for 2021-04-19-40-6

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

Project Information

DEA: 010F4704
EFIS: 0116000011
Project ID: 215179
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-299-30.7/37.7
Work Description: PLACE HMA & RHMA-G & CONSTRUCT SOLDIER PILE WALL.
Location Description: HUMBOLDT COUNTY NEAR WILLOW CREEK AT VARIOUS LOCATIONS FROM 0.1 MILE EAST OF CEDAR CREEK ROAD TO 1.1 MILES WEST OF ROUTE 96 JUNCTION
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Brian Winter
Structure Rep.: Jarred Burrows

Sample Information

DIME Sample ID: 2021-04-19-40
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Dispute Resolution
Type of Material: Aggregate
Sample Taken Date: 4/19/2021
Date that the sample was received by the laboratory/organization performing the testing: 6/8/2021
The quantity of what the sample constitutes: 2 bags
A brief description of the sample: 3/4" HMA PG64-16 NO RAP
From where was the sample collected: Manufacturer
Laboratory sample identification: 21-JMFDP-0110
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Mercer Fraser - Willow Creek

Material Information

Source Identification (SMARA or name of Pit): 91-12-0007
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: Plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number:

Test Information

DIME Test ID: 2021-04-19-40-6
Test Method: ASTM D4791-10: Standard Test Method for Flat Particles, Elongated Particles, or Flat and Elongated Particles in Coarse Aggregate (Withdrawn 2019) (Flat and Elongated Particles)
Date Tested: 6/17/2021
Verified Date: 6/18/2021
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bang.d.nguyen@dot.ca.gov
Organization Phone: (916) 227-7204
General Comments for this Test: % by mass at 5:1
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Method: B
Determination: By Mass
Dimensional ratio used: 5:1
Weighted percentage of particles (by mass) that were flat and elongated: no data
Weighted percentage of particles (by mass) that were not flat and elongated: 100 %