Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
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
DIME Sample ID: 2025-04-17-91
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: Hot Mix Asphalt
Sample Taken Date: 04/17/2025
Date that the sample was received by the laboratory/organization performing the testing: 04/17/2025
The quantity of what the sample constitutes: 1 box, 1 Core
A brief description of the sample: 1-2-A Core
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: BoDean Santa Rosa
DIME Test ID: 2025-04-17-91-1
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: 06/18/2025
Date Tested: 04/18/2025
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: Rice t-275 Test
Test Result Compliance: not applicable
Additional Comments When Verified:
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Bulk Specific Gravity
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2.431
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