Project Information

Project ID: 995255 DEA: 041J9604 EFIS: 0414000403 QA Service Level: 1

DIST-CO-RTE-PM: 04-MRN-1-22.8/33.0,45.0/50.5

Work Description: COLD PLANE, RHMA, HMA, MGS, CURB RAMPS, SIDEWALKS, AND CULVERTS.

Location Description: MARIN COUNTY IN AND NEAR POINT REYES STATION FROM FIVE BROOKS TO 1.9 MILES NORTH OF CYPRESS ROAD AND IN AND NEAR TOMALES FROM 0.2 MILES SOUTH OF TOMALES TO 4.4 MILES NORTH OF TOMALES

Contractor Name: O.C. JONES & SONS, INC.

Contractor Address: Unknown

Resident Engineer: Andrew Wong Structure Rep.: Jeremy Light

Sample Information

DIME Sample ID: 2025-05-09-39

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: Aggregate

Sample Taken Date: 05/09/2025

Date that the sample was received by the laboratory/organization performing the testing: 05/12/2025

The quantity of what the sample constitutes: 750 Tons

A brief description of the sample: 1/2" hma wma

From where was the sample collected: Manufacturer

Laboratory sample identification:

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: BoDean Company

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-49-0032

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: Batch Plant Hot Bins

Where the material sample would have been placed if not sampled:

Primary Aggregate Nominal Size: 1/2 inch

The concrete mix design number:

Lot number: 1

Sublot number: 13

Aggregate Mix Number: 600SPW

Test Results

Test 1 of 2

DIME Test ID: 2025-05-09-39-1

Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)

Verified Date: 05/16/2025

Date Tested: 05/12/2025

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 type of gradation is being tested?	HMA Gradation
Cumulative percent passing the 2 in. sieve	no data
Cumulative percent passing the 1 1/2 in. sieve	100 %
Cumulative percent passing the 1 in. sieve	100 %
Cumulative percent passing the 3/4 in. sieve	100 %
Cumulative percent passing the 1/2 in. sieve	98 %
Cumulative percent passing the 3/8 in. sieve	89 %
Cumulative percent passing the #4 sieve	53 %
Cumulative percent passing the #8 sieve	32 %
Cumulative percent passing the #16 sieve	22 %
Cumulative percent passing the #30 sieve	12 %
Cumulative percent passing the #50 sieve	5 %
Cumulative percent passing the #100 sieve	3 %
Cumulative percent passing the #200 sieve	2.5 %

Test 2 of 2

DIME Test ID: 2025-05-09-39-2

Test Method: AASHTO T176-08: Standard Method of Test for Plastic Fines in Graded Aggregates and Soils by Use of the Sand Equivalent Test (Sand Equivalent)