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Testing Report for 2021-06-07-42-2

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

Project Information

DEA: 112N0574
EFIS: 1119000079
Project ID: 215559
QA Service Level: 1
DIST-CO-RTE-PM: 11-IMP-86-L8.4/8.8
Work Description: COLD PLANE AND PAVE WITH STRESS ABSORBING MEMBRANE INTERLAYER AND HMA.
Location Description: IMPERIAL COUNTY IN EL CENTRO FROM 0.1 MILE EAST OF NORTH IMPERIAL AVENUE TO TRESHILL ROAD.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Benjamin Haney
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-06-07-42
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: Crumb Rubber Modifier
Sample Taken Date: 6/7/2021
Date that the sample was received by the laboratory/organization performing the testing: 8/20/2021
The quantity of what the sample constitutes: 1 Bag of Hi-Natural Crumb Rubber
A brief description of the sample: Hi-Nat 5500 for Chip Seal
From where was the sample collected: Manufacturer
Laboratory sample identification: 4526
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Not Provided

Material Information

CRM Type: High Natural

Test Information

DIME Test ID: 2021-06-07-42-2
Test Method: CTM 208-September 2011: Method of Test for Apparent Specific Gravity of Fine Aggregates
Date Tested: 8/23/2021
Verified Date: 8/24/2021
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

Specific Gravity: 1.16