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Testing Report for 2021-08-20-44-7

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

Project Information

DEA: 040A5394
EFIS: 0418000244
Project ID: 214114
QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-80,12-11.4/12.8, 2.1/2.8
Work Description: Widen EB SR-12 Connector, Construct 3 ramps & 2 box girder bridges, remove existing bridge, etc.
Location Description: I-80/I-680/Route 12 Interchange
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Fernando Dos Santos
Structure Rep.: Alejandro Lara

Sample Information

DIME Sample ID: 2021-08-20-44
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - DME / District Lab
Sample Organization Contact: (510) 507-3456
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 8/20/2021
Date that the sample was received by the laboratory/organization performing the testing: 8/20/2021
The quantity of what the sample constitutes: 4 Bags
A brief description of the sample: 4 Bags of Mixed Aggregate
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: SYAR Lake Herman Drum

Material Information

Source Identification (SMARA or name of Pit): 91-48-0002
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: Sampling Point of the Plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number:
Sublot number:

Test Information

DIME Test ID: 2021-08-20-44-7
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: 8/31/2021
Verified Date: 9/15/2021
Submitted By Organization: CT D04 - DME / District Lab
Organization Address: 21339 Cabot Blvd,
Organization City: Hayward
Organization State: CA
Organization Zipcode: 94545
Organization Email:
Organization Phone: (510) 507-3456
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Number of tests: 2
Mass Determination: Air
Specific Gravity for Sample 1: 2.434
Specific Gravity for Sample 2: 2.432
Average Specific Gravity: 2.433