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Sample Record for 2021-04-23-21

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Project Information

Project ID: 215251 DEA: 021J4604 EFIS: 0220000081 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-96-34.5/38.8,88.0/92.0
Work Description: HMA OVERLAY, REPLACE AC SURFACING, SHOULDER BACKING & TRAFFIC STRIPE.
Location Description: SISKIYOU COUNTY NEAR HAPPY CAMP FROM 0.1 MILE EAST OF OAK FLAT CREEK BRIDGE TO 0.1 MILE EAST OF BENJAMIN CREEK ROAD AND FROM 0.3 MILE WEST OF BEAVER CREEK BRIDGE TO 1.0 MILE WEST OF LUMGREY CREEK BRIDGE
Contractor Name: TULLIS, INC.
Contractor Address: 16951 CLEAR CREEK ROAD, REDDING CA 96001
Resident Engineer: Austin Henry Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-04-23-21
TL Number from the TL Form: 858621
Sample Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Sample Organization Contact: (530) 225-3194
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 04/23/2021
Date that the sample was received by the laboratory/organization performing the testing: 04/23/2021
The quantity of what the sample constitutes: JMF Verification
A brief description of the sample: 3/8" Sized Untreated Aggregate
From where was the sample collected: Source
Laboratory sample identification: D78785B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Shasta Ranch Aggregates - Anderson, CA

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-45-0057
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: Sized Untreated Stockpile
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/8 inch
The concrete mix design number: JMF 21-05-S01
Lot number:
Sublot number:
Aggregate Mix Number:

Test Results

Test 1 of 2

DIME Test ID: 2021-04-23-21-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 06/22/2021
Date Tested: 04/27/2021
Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Organization Address: 1657 Riverside Drive,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: 530-225-3194
General Comments for this Test:
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 100 %
Cumulative percent passing the 1/2 in. sieve 100 %
Cumulative percent passing the 3/8 in. sieve 99.1 %
Cumulative percent passing the 1/4 in. sieve 56.8 %
Cumulative percent passing the #4 sieve 27.1 %
Cumulative percent passing the #8 sieve 5 %
Cumulative percent passing the #16 sieve 3.2 %
Cumulative percent passing the #30 sieve 2.6 %
Cumulative percent passing the #50 sieve 2.1 %
Cumulative percent passing the #100 sieve 1.8 %
Cumulative percent passing the #200 sieve 1.43 %

Test 2 of 2

DIME Test ID: 2021-04-23-21-2
Test Method: AASHTO T104-99r16: Standard Method of Test for Soundness of Aggregate by Use of Sodium Sulfate or Magnesium Sulfate (Soundness)
Verified Date: 07/22/2021
Date Tested: 07/22/2021
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
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:
Test Result Compliance:
Additional Comments When Verified:
Size of aggregate being tested Fine Aggregate
What type of solution was used? Sodium sulfate
What was the condition of the solution? Freshly prepared
Number of immersion cycles performed 5
Fine weighted average loss 2 %