Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993333 DEA: 04264724 EFIS: 0419000068
QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-101-R20.8/27.1
Work Description: CIP BRIDGES, CONSTRUCT ROADWAY, RETAINING WALLS AND MODIFY ELECTRICAL.
Location Description: MARIN COUNTY IN AND NEAR NOVATO FROM 0.1 MILE SOUTH OF FRANKLIN AVENUE OVERHEAD TO 0.5 MILE SOUTH OF SAN ANTONIO CREEK BRIDGE
Contractor Name: GHILOTTI CONSTRUCTION CO. INC. (RILEY GENAZZI & JOSH SERAFINO)
Contractor Address: 246 GHILOTTI AVE., SANTA ROSA, CA 95407
Resident Engineer: Fabio La Serna Structure Rep.: Jeremy Light
DIME Sample ID: 2024-11-20-71
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Petaluma Field Laboratory
Sample Organization Contact: (510) 385-6841
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 11/20/2024
Date that the sample was received by the laboratory/organization performing the testing: 11/21/2024
The quantity of what the sample constitutes: 2 BOXES
A brief description of the sample: 3/4" hma
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: DUTRA SAN RAFAEL
DIME Test ID: 2024-11-20-71-1
Test Method: AASHTO T308-10: Standard Method of Test for Determining the Asphalt Binder Content of Hot Mix Asphalt (HMA) by the Ignition Method (Method A) (Asphalt Binder Content)
Verified Date: 03/19/2025
Date Tested: 11/21/2024
Submitted By Organization: CT D04 - Petaluma Field Laboratory
Organization Address: 5675 Gibraltar Drive,
Organization City: Pleasanton
Organization State: CA
Organization Zipcode: 94588
Organization Email: glenn.cea@dot.ca.gov
Organization Phone: (510) 385-6841
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
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What temperature unit is used?
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Celsius
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Test procedure used?
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Method A
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Mass of HMA Sample prior to ignition
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2052.6 g
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Corrected Asphalt Binder Content
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5.54 %
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Mass Loss
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139.8 g
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Correction Factor (Percent by mass of HMA Specimen)
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1.1 %
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Moisture Content
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no data0 %
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Temperature Compensation Factor
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0.17 %
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Test Temperature
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482 C
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DIME Test ID: 2024-11-20-71-2
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: 03/19/2025
Date Tested: 12/02/2024
Submitted By Organization: CT D04 - Petaluma Field Laboratory
Organization Address: 5675 Gibraltar Drive,
Organization City: Pleasanton
Organization State: CA
Organization Zipcode: 94588
Organization Email: glenn.cea@dot.ca.gov
Organization Phone: (510) 385-6841
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Bulk Specific Gravity
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2.387
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DIME Test ID: 2024-11-20-71-3
Test Method: AASHTO T269-14: Standard Method of Test for Percent Air Voids in Compacted Dense and Open Asphalt Mixtures (Air Void)
Verified Date: 03/19/2025
Date Tested: 12/02/2024
Submitted By Organization: CT D04 - Petaluma Field Laboratory
Organization Address: 5675 Gibraltar Drive,
Organization City: Pleasanton
Organization State: CA
Organization Zipcode: 94588
Organization Email: glenn.cea@dot.ca.gov
Organization Phone: (510) 385-6841
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
