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Sample Record for 2024-12-20-36

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

Project Information

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

Sample Information

DIME Sample ID: 2024-12-20-36
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: 12/20/2024
Date that the sample was received by the laboratory/organization performing the testing: 12/23/2024
The quantity of what the sample constitutes: 4 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

Material Information

HMA Type: Type A HMA
HMA Grading: 3/4 inch
Lot number: 14
Sublot number: 1
HMA Mix Number: L210143WMA
Binder content (%):
Virgin binder PG:
Design binder PG:
Binder Supplier:
RAP content (%):
WMA Additives:
Antistrip type:
Test results on following page(s): 4

Test Results

Test 1 of 4

DIME Test ID: 2024-12-20-36-1
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: 01/07/2025
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:
What temperature unit is used? Celsius
Test procedure used? Method A
Mass of HMA Sample prior to ignition 2039.3 g
Corrected Asphalt Binder Content 5.37 %
Mass Loss 135.4 g
Correction Factor (Percent by mass of HMA Specimen) 1.1 %
Moisture Content no data0 %
Temperature Compensation Factor 0.17 %
Test Temperature 482 C

Test 2 of 4

DIME Test ID: 2024-12-20-36-2
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Verified Date: 03/19/2025
Date Tested: 01/07/2025
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: not applicable
Additional Comments When Verified:
Number of tests 1
What is the unit of measurement for theoretical density? SI Units
Mass Determination Air
Specific Gravity for Sample 1 2.465
Theoretical maximum density at 25°C (77°F) 2457.9 kg/m^3

Test 3 of 4

DIME Test ID: 2024-12-20-36-3
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: 03/19/2025
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:
Bulk Specific Gravity 2.392
Bulk Specific Gravity 2 2.384
Bulk Specific Gravity 3 2.392
Average Bulk Specific Gravity 2.389

Test 4 of 4

DIME Test ID: 2024-12-20-36-4
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: 01/07/2025
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:
Percent Air Voids 3 %
Percent Air Voids 2 3.3 %
Percent Air Voids 3 3 %
Average Percent Air Voids 3.1 %
Average Core Density 96.9 %