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Testing Report for 2019-06-03-9-3

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

Project Information

DEA: 083555V4
EFIS: 0814000086
Project ID: 210569
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-42.5/46.0
Work Description: WIDEN I-15, RECONSTRUCT 3 IC'S, CONSTRUCT 2 NEW BR AND WIDEN 3 BR.
Location Description: SAN BERNARDINO COUNTY IN VICTORVILLE FROM 0.5 MILE NORTH OF MOJAVE DRIVE TO 1.5 MILE NORTH OF STODDARD WELLS ROAD OVERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Taghreed Al-Khateeb
Structure Rep.: Ravinder Singh

Sample Information

DIME Sample ID: 2019-06-03-9
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: 6/3/2019
Date that the sample was received by the laboratory/organization performing the testing: 6/7/2019
The quantity of what the sample constitutes: JMF 12 bags
A brief description of the sample: 1/2 HMA-A-SP R25
From where was the sample collected: Manufacturer
Laboratory sample identification: 0330A-19
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Diamond Oro Grande, Cemex White Mountain

Material Information

Source Identification (SMARA or name of Pit): Blue Diamond Oro Grande, Cemex White Mountain
The fabricator's/manufacturer's product name for the sample: 1/2 HMA-A-SP R25
The fabricator/manufacturer designation for the sample: 300215 R25
The plant number: Unknown
A detailed description of where the material sample was collected: Belt Cut at Plant
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number: Unknown
Lot number: Unknown
Sublot number: Unknown

Test Information

DIME Test ID: 2019-06-03-9-3
Test Method: AASHTO T85-13: Standard Method of Test for Specific Gravity and Absorption of Coarse Aggregate (Coarse Specific Gravity)
Date Tested: 6/10/2019
Verified Date: 7/3/2019
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: 2.709
Absorption: 0.6 %