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Testing Report for 2021-06-09-28-2

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

Project Information

DEA: 080K8404
EFIS: 0800020563
Project ID: 214543
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-L5726-
Work Description: MAINTENANCE STATION BUILDING WORK.
Location Description: SAN BERNARDINO AT THE SAN BERNARDINO MAINTENANCE STATION AT 175 WEST CLUSTER STREET
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Nicholas Mineo
Structure Rep.: Tim Flores

Sample Information

DIME Sample ID: 2021-06-09-28
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: 6/9/2021
Date that the sample was received by the laboratory/organization performing the testing: 6/16/2021
The quantity of what the sample constitutes: 2 Boxes
A brief description of the sample: HMA Type A SP R15 #224112
From where was the sample collected: Source
Laboratory sample identification: 3A
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Corona

Material Information

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

Test Information

DIME Test ID: 2021-06-09-28-2
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: 6/21/2021
Verified Date: 6/28/2021
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: 2.489