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Testing Report for 2019-04-30-6-3

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

Project Information

DEA: 07303404
EFIS: 0714000006
Project ID: 213306
QA Service Level: 1
DIST-CO-RTE-PM: 07-VEN-33-0.0/6.3
Work Description: COLD PLANE AC PVMT, PLACE RUBBERIZED AC (TYPE G), AND REPLACE PCC PVMT
Location Description: VENTURA COUNTY IN AND NEAR VENTURA FROM ROUTE 33/101 SEPARATION TO 0.1 MILE SOUTH OF PARK VIEW DRIVE
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Houshang Shohet
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-04-30-6
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: 4/30/2019
Date that the sample was received by the laboratory/organization performing the testing: 5/3/2019
The quantity of what the sample constitutes: PSE 4 bags
A brief description of the sample: 3/4 HMA-A-SP
From where was the sample collected: Manufacturer
Laboratory sample identification: 0260A-19
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sheldon, Big Rock Creek, Palmdale

Material Information

Source Identification (SMARA or name of Pit): 91-19-0017, 91-19-0019, 09-91-0021
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: 220831 SAT VLO
The plant number: Unknown
A detailed description of where the material sample was collected: Manufacturer
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: Unknown
Lot number: Unknown
Sublot number: Unknown

Test Information

DIME Test ID: 2019-04-30-6-3
Test Method: AASHTO T85-13: Standard Method of Test for Specific Gravity and Absorption of Coarse Aggregate (Coarse Specific Gravity)
Date Tested: 5/4/2019
Verified Date: 5/30/2019
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

Basis for relative density testing: Bulk
Specific Gravity: 2.653
Absorption: 1 %