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Testing Report for 2021-08-20-54-2

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: 2021-08-20-54
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: Reclaimed Asphalt Pavement
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: 1 Bag RAP
A brief description of the sample: 1 Bag of RAP Sampled pt e plant
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

RAP Source: Lake Herman Quarry
Aggregate Size:
Aggregate Source:
RAP Stockpile:
Stockpile Size (tons):

Test Information

DIME Test ID: 2021-08-20-54-2
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: 8/31/2021
Verified Date: 9/22/2021
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: 2.533
Specific Gravity for Sample 2: 2.535
Average Specific Gravity: 2.534