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Sample Record for 2025-10-11-13

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Project Information

Project ID: 993595 DEA: 042Q5504 EFIS: 0419000024 QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-12-7.9/14.1
Work Description: RHMA OVERLAY, REPLACE CULVERTS, BRIDGE RAILS, AND MEDIAN BARRIERS.
Location Description: SOLANO COUNTY NEAR SUISUN CITY FROM 0.2 MILE EAST OF LAWLER RANCH PARKWAY TO 0.5 MILE EAST OF SHILOH ROAD
Contractor Name: BAY CITIES PAVING & GRADING, INC.
Contractor Address: 1450 Civic Court B#400, Concord, CA 94520
Resident Engineer: Asadullah Sarwary Structure Rep.: Kambiz Kouchesfahani

Sample Information

DIME Sample ID: 2025-10-11-13
TL Number from the TL Form: CON-101125-1
Sample Submitted By Organization: CT D04 - Hayward DME / District Laboratory
Sample Organization Contact: (510) 507-3456
Type of Sample: Production Start-Up
Type of Material: Aggregate
Sample Taken Date: 10/11/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/23/2025
The quantity of what the sample constitutes: 2 Bags per bin#1-4
A brief description of the sample: 3/4" HMA-SP + 15% RAP
From where was the sample collected: Manufacturer
Laboratory sample identification: D04-SE-25-072
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Woodland (BP)

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-57-0004
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: At the plant
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: 2
Sublot number: 1
Aggregate Mix Number: 30640432407V

Test Results

Test 1 of 4

DIME Test ID: 2025-10-11-13-1
Test Method: AASHTO T335-09r13: Standard Method of Test for Determining the Percentage of Fracture in Coarse Aggregate (Percent of Crushed Particles)
Submitted By Organization: BSK Associates
Organization Address: 399 Lindbergh Avenue,
Organization City: Livermore
Organization State: CA
Organization Zipcode: 94551
Organization Email: cmelo@bskassociates.com
Organization Phone: (925) 765-9483
Data has not been verified.

Test 2 of 4

DIME Test ID: 2025-10-11-13-2
Test Method: AASHTO T96-02r10: Standard Method of Test for Resistance to Degradation of Small-Size Coarse Aggregate by Abrasion and Impact in the Los Angeles Machine (Los Angeles Rattler)
Submitted By Organization: BSK Associates
Organization Address: 399 Lindbergh Avenue,
Organization City: Livermore
Organization State: CA
Organization Zipcode: 94551
Organization Email: cmelo@bskassociates.com
Organization Phone: (925) 765-9483
Data has not been verified.

Test 3 of 4

DIME Test ID: 2025-10-11-13-3
Test Method: AASHTO T304-11: Standard Method of Test for Uncompacted Void Content of Fine Aggregate (Fine of Crushed Particles)
Submitted By Organization: BSK Associates
Organization Address: 399 Lindbergh Avenue,
Organization City: Livermore
Organization State: CA
Organization Zipcode: 94551
Organization Email: cmelo@bskassociates.com
Organization Phone: (925) 765-9483
Data has not been verified.

Test 4 of 4

DIME Test ID: 2025-10-11-13-4
Test Method: ASTM D4791-10: Standard Test Method for Flat Particles, Elongated Particles, or Flat and Elongated Particles in Coarse Aggregate (Withdrawn 2019) (Flat and Elongated Particles)
Submitted By Organization: BSK Associates
Organization Address: 399 Lindbergh Avenue,
Organization City: Livermore
Organization State: CA
Organization Zipcode: 94551
Organization Email: cmelo@bskassociates.com
Organization Phone: (925) 765-9483
Data has not been verified.