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Sample Record for 2025-05-13-18

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

Project Information

Project ID: 993454 DEA: 040K8004 EFIS: 0416000141 COOP: 042892 QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-101-13.7
Work Description: CONSTRUCT ROUNDABOUT, CURB RAMPS AND SW, SIGNAL AND LIGHTING SYSTEMS.
Location Description: MARIN COUNTY IN SAN RAFAEL AT FREITAS PARKWAY OVERCROSSING
Contractor Name: GHILOTTI BROS., INC.
Contractor Address: 525 JACOBY STREET, SAN RAFAEL CA 94901
Resident Engineer: Dawit Habteselassie Structure Rep.: Jeremy Light

Sample Information

DIME Sample ID: 2025-05-13-18
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Richmond Field Laboratory
Sample Organization Contact: (510) 231-7151
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 05/13/2025
Date that the sample was received by the laboratory/organization performing the testing: 05/13/2025
The quantity of what the sample constitutes: 2 Cylinders
A brief description of the sample: 3/4" Recycled class 2 AB
From where was the sample collected: Job Site
Laboratory sample identification: Rich_25_160
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Ghilotti silveria Yard

Material Information

Source Identification (SMARA, name of Pit or Job Site): 0000000000
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Job Site
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2025-05-13-18-1
Test Method: CTM 216-June 2011: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates
Verified Date: 05/14/2025
Date Tested: 05/13/2025
Submitted By Organization: CT D04 - Richmond Field Laboratory
Organization Address: 3401 Regatta Boulevard,
Organization City: Richmond
Organization State: CA
Organization Zipcode: 94508
Organization Email: santiago.sequeira@dot.ca.gov
Organization Phone: (510) 385-7641
General Comments for this Test: Class 2 Recycle AB
Test Result Compliance: complies
Additional Comments When Verified:
Is oversize material No
In-place wet density 2.14
Highest adjust wet density 2.29
Relative compaction 93
% Moisture 13.2 %
Optimum Moisture 13.2 %

Test 2 of 2

DIME Test ID: 2025-05-13-18-2
Test Method: CTM 231-March 2013: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates Using Nuclear Gages
Verified Date: 05/14/2025
Date Tested: 05/13/2025
Submitted By Organization: CT D04 - Richmond Field Laboratory
Organization Address: 3401 Regatta Boulevard,
Organization City: Richmond
Organization State: CA
Organization Zipcode: 94508
Organization Email: santiago.sequeira@dot.ca.gov
Organization Phone: (510) 385-7641
General Comments for this Test: Recycle Class 2 AB
Test Result Compliance: complies
Additional Comments When Verified:
Sum of Count or Density 86333 g/cc
Average of Count or Density 28777 g/cc
Sum of Moisture Count 7947 g/cc
Average of Moisture Count 2649 g/cc
Count Ratio Density 2.14
Count Ratio Moisture 0.25
Calculated Percent Relative Compaction 93.4 %
Reported Percent Relative Compaction 93 %