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Testing Report for 2021-07-08-25-6

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

Project Information

DEA: 080F5444
EFIS: 0818000209
Project ID: 215224
QA Service Level: 2
DIST-CO-RTE-PM: 08-RIV-91-17.4/18.9
Work Description: Operational and safety improvements by constructing a portion of the Ultimate SR?91 CIP Project on WB SR?91 from Green River Road to SR?241 to alleviate traffic congestion in this area (ORA Post Mile R17.4 to R18.9, RIV Post Mile R0.0 to R0.6).
Location Description: The 91 COP consists of the following project components: adding a general purpose (GP) lane approximately 2 miles in length in the WB direction on SR?91 from Green River Road to SR?241.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Denise Sostrum
Structure Rep.: Luis Negrete

Sample Information

DIME Sample ID: 2021-07-08-25
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: 7/8/2021
Date that the sample was received by the laboratory/organization performing the testing: 7/15/2021
The quantity of what the sample constitutes: 4 Bags Of Coldfeed Agg., 1 Bag Rap
A brief description of the sample: JMF 3/8" HMA-A, R15
From where was the sample collected: Manufacturer
Laboratory sample identification: 0412A-21
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: R J Noble Orange

Material Information

Source Identification (SMARA or name of Pit): 91-33-0035
The fabricator's/manufacturer's product name for the sample: 3/8 HMA-A R15
The fabricator/manufacturer designation for the sample:
The plant number: 44R1504SPO
A detailed description of where the material sample was collected: Belt Cut at RJ Noble Orange Plant
Where the material sample would have been placed if not sampled: Asphalt Paving
Primary Aggregate Nominal Size: 3/8 inch
The concrete mix design number:
Lot number:
Sublot number:

Test Information

DIME Test ID: 2021-07-08-25-6
Test Method: AASHTO T304-11: Standard Method of Test for Uncompacted Void Content of Fine Aggregate (Fine of Crushed Particles)
Date Tested: 7/22/2021
Verified Date: 7/26/2021
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

What test method is performed?: Method A
Bulk dry specific gravity: 2.688
Average uncompacted voids: 49 %