Project Information

Project ID: 1000435 DEA: 030J01U4 EFIS: 0323000244 QA Service Level: 1

DIST-CO-RTE-PM: 03-PLA-28-0.1/11.0

Work Description: HMA (TYPE A), COLD PLANE AC PVMT, RDWY EXC, & CL 2 AB.

Location Description: PLACER COUNTY FROM 0.1 MILE EAST OF ROUTE 89 AT TAHOE CITY TO THE NEVADA STATE LINE AT KINGS BEACH

Contractor Name: MERCER-FRASER COMPANY

Contractor Address: PO Box 1006, Eureka, CA 95502

Resident Engineer: Reza Salehi Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2025-10-07-77

TL Number from the TL Form:

Sample Submitted By Organization: CT D03 - Olivehurst Northern Regional Laboratory

Sample Organization Contact: (530) 741-4238

Type of Sample: Quality Assurance

Type of Material: Hot Mix Asphalt

Sample Taken Date: 10/07/2025

Date that the sample was received by the laboratory/organization performing the testing: 10/14/2025

The quantity of what the sample constitutes: 2 Boxes

A brief description of the sample: 1/2" HMA w/ 15% RAP

From where was the sample collected: Source

Laboratory sample identification: Daily 25-220

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: Teichert Martis

Material Information

HMA Type: Type A HMA

HMA Grading: 1/2 inch

Lot number: 1

Sublot number: 1

HMA Mix Number: 30540742407P

Binder content (%): 5.8

Virgin binder PG:

Design binder PG: PG 64-28

Binder Supplier: PNW

RAP content (%): 15

WMA Additives: No

Antistrip type:

Test Results

Test 1 of 2

DIME Test ID: 2025-10-07-77-1

Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)

Verified Date: 11/06/2025

Date Tested: 11/03/2025

Submitted By Organization: CT D03 - Olivehurst Northern Regional Laboratory

Organization Address: 5330 Arboga Road,

Organization City: Olivehurst

Organization State: CA

Organization Zipcode: 95961

Organization Email: jeff.herbert@dot.ca.gov

Organization Phone: (530) 741-4238

General Comments for this Test:

Test Result Compliance: not applicable

Additional Comments When Verified:

Number of tests	1
What is the unit of measurement for theoretical density?	SI Units
Mass Determination	Air
Method Performed	Mechanical Agitation - Method A
Mass of container filled with water	7402.5 grams
Mass of oven-dry sample in air for Sample 1	1596.2 grams
Mass of container filled with the sample and water for Sample 1	8349.8 grams
Temperature of Water	77 °F
Specific Gravity for Sample 1	2.46
Theoretical maximum density at 25°C (77°F)	2452.9 kg/m^3

Test 2 of 2

DIME Test ID: 2025-10-07-77-2

Test Method: AASHTO T308-10: Standard Method of Test for Determining the Asphalt Binder Content of Hot Mix Asphalt (HMA) by the Ignition Method (Method A) (Asphalt Binder Content)