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Sample Record for 2025-10-27-3

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

Project Information

Project ID: 1000682 DEA: 09379104 EFIS: 0919000005 QA Service Level: 1
DIST-CO-RTE-PM: 09-INY-395-91.6/100.8
Work Description: CONSTRUCT HMA, CURB RAMPS, AND ELECTRICAL SYSTEMS.
Location Description: INYO COUNTY AT AND NEAR BIG PINE FROM 0.1 MILE SOUTH OF ELNA ROAD TO SOUTH JUNCTION ROUTE 168
Contractor Name: ROAD AND HIGHWAY BUILDERS, LLC.
Contractor Address: P.O. Box 70846, Reno, N V, 89570
Resident Engineer: Adam Zumstein Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2025-10-27-3
TL Number from the TL Form:
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 10/27/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/27/2025
The quantity of what the sample constitutes: up to 250 tons each
A brief description of the sample: CR161 A
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RHB Plant Independence

Material Information

HMA Type: Type A HMA
HMA Grading: 3/4 inch
Lot number:
Sublot number:
HMA Mix Number:
Binder content (%): 0.0
Virgin binder PG:
Design binder PG:
Binder Supplier:
RAP content (%):
WMA Additives:
Antistrip type:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2025-10-27-3-1
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: 10/29/2025
Date Tested: 10/28/2025
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
General Comments for this Test: CR-161
Test Result Compliance: complies
Additional Comments When Verified:
Bulk Specific Gravity 2.316

Test 2 of 2

DIME Test ID: 2025-10-27-3-2
Test Method: AASHTO T269-14: Standard Method of Test for Percent Air Voids in Compacted Dense and Open Asphalt Mixtures (Air Void)
Verified Date: 10/29/2025
Date Tested: 10/28/2025
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
General Comments for this Test: CR-160 Density: 161A=93.0%
Test Result Compliance: complies
Additional Comments When Verified:
Percent Air Voids 7 %