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Testing Report for 2020-06-22-19-7

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

Project Information

DEA: 080C70U4
EFIS: 0815000189
Project ID: 212302
QA Service Level: 2
DIST-CO-RTE-PM: 08-SBD-210-PM R 25
Work Description: The SR 210 Base Line Interchange project, in the City of Highland, includes widening of the Base Line overcrossing at the SR 210, along with additional ramp widening improvements for the northbound on-ramp, northbound off-ramp and southbound on-ramps.
Location Description: SR210 Lane Addition work proposes to improve SR 210 within the cities of Highland, Redlands, San Bernardino and unincorporated sections of San Bernardino County,
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Khalid Bazmi
Structure Rep.: Matt Bruce

Sample Information

DIME Sample ID: 2020-06-22-19
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: 6/22/2020
Date that the sample was received by the laboratory/organization performing the testing: 6/22/2020
The quantity of what the sample constitutes: 4 Bags Combined Coldfeed agg. 4 Bags Rap
A brief description of the sample: 3/4" HMA-A-SP R15 No LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0401A-20
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA-Corona

Material Information

Source Identification (SMARA or name of Pit): 91-33-0005
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
The plant number: 105927
A detailed description of where the material sample was collected: Conveyor Belt
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: 2020-06-22-19-7
Test Method: ASTM D4791-10: Standard Test Method for Flat Particles, Elongated Particles, or Flat and Elongated Particles in Coarse Aggregate (Withdrawn 2019) (Flat and Elongated Particles)
Date Tested: 7/14/2020
Verified Date: 7/16/2020
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

Method: B
Determination: By Mass
Dimensional ratio used: 5:1
Weighted percentage of particles (by mass) that were flat and elongated: no data
Weighted percentage of particles (by mass) that were not flat and elongated: 100 %