Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000783 DEA: 041Q7004 EFIS: 0418000319
QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-101-22.8/32.8
Work Description: REPLACE BRIDGE RAILING AND GUARDRAIL, & RECONSTRUCT SIDEWALK.
Location Description: SONOMA COUNTY AT VARIOUS LOCATIONS FROM MENDOCINO AVENUE OVERCROSSING TO LIMERICK LANE OVERCROSSING
Contractor Name: GHILOTTI CONSTRUCTION COMPANY, INC.
Contractor Address: Unknown
Resident Engineer: Leonard Brajnikoff Structure Rep.: Nick Abuhamdieh
DIME Sample ID: 2025-09-04-8
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Petaluma Field Laboratory
Sample Organization Contact: (510) 385-6841
Type of Sample: Acceptance
Type of Material: Polyester
Sample Taken Date: 09/04/2025
Date that the sample was received by the laboratory/organization performing the testing: 09/04/2025
The quantity of what the sample constitutes: MULTI LANES
A brief description of the sample: POLYESTER CONCRTE COMPACTION TEST
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier: 20-0179
Structure name: MENDOCINO AVE OH 101 SONOMA COUNTY
The fabricator/manufacturer/facility name: kwik Bond, Benecia -DBE ENGINEERING
DIME Test ID: 2025-09-04-8-1
Test Method: CTM 552-December 2013: Method of Test for Relative Compaction of Polymer Concrete Utilizing Nuclear Gages
Verified Date: 10/14/2025
Date Tested: 09/18/2025
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:
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Gage No.
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688
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Time of test
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09:30 HH:MM
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Standard Density
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2.24 g/cc
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In-Place Density
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2.2 g/cc
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Percent Relative Compaction
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98 %
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