Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215401 DEA: 040Q3004 EFIS: 0418000069 COOP: 042776
QA Service Level: 2
DIST-CO-RTE-PM: 04-ALA-680-R10.6/R21.9
Work Description: I-680 Southbound express lanes and rehabilitation
Location Description: I- 680 Southbound from State Route (SR) 84 to Alcosta Boulevard in Alameda County
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2025-03-11-22
TL Number from the TL Form: C031489
Sample Submitted By Organization: CT D04 - Pleasanton Field Laboratory
Sample Organization Contact: (510) 224-6127
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 03/11/2025
Date that the sample was received by the laboratory/organization performing the testing: 03/12/2025
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4 HMA-SP Type A
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Pleasanton
DIME Test ID: 2025-03-11-22-1
Test Method: AASHTO T275-07r12: Standard Method of Test for Bulk Specific Gravity (Gmb) of Compacted Asphalt Mixtures Using Paraffin-Coated Specimens (Bulk Specific Gravity)
Verified Date: 03/17/2025
Date Tested: 03/17/2025
Submitted By Organization: CT D04 - Pleasanton Field Laboratory
Organization Address: 5675 B Gibratar Drive,
Organization City: Pleasanton
Organization State: CA
Organization Zipcode: 94588
Organization Email: dennis.yeung@dot.ca.gov
Organization Phone: (510) 224-6127
General Comments for this Test: Lot 8 Sublot 4
Test Result Compliance: not applicable
Additional Comments When Verified:
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Bulk Specific Gravity
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2.408
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DIME Test ID: 2025-03-11-22-2
Test Method: AASHTO T269-14: Standard Method of Test for Percent Air Voids in Compacted Dense and Open Asphalt Mixtures (Air Void)
Verified Date: 03/17/2025
Date Tested: 03/17/2025
Submitted By Organization: CT D04 - Pleasanton Field Laboratory
Organization Address: 5675 B Gibratar Drive,
Organization City: Pleasanton
Organization State: CA
Organization Zipcode: 94588
Organization Email: dennis.yeung@dot.ca.gov
Organization Phone: (510) 224-6127
General Comments for this Test: Lot 8 Sublot 4
Test Result Compliance: complies
Additional Comments When Verified: