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Sample Record for 2025-10-17-44

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Project Information

Project ID: 995493 DEA: 081G6704 EFIS: 0816000049 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-79-5.4/11.4
Work Description: HOT MIX ASPHALT, SOIL NAIL, STRUCTURAL CONCRETE AND ROADWAY EXC.
Location Description: RIVERSIDE COUNTY NEAR TEMECULA FROM 0.4 MILE SOUTH OF SAGE ROAD TO 1.1 MILES SOUTH OF PAUBA ROAD
Contractor Name: ORTIZ ENTERPRISES, INC.
Contractor Address: 6 CUSHING STE 200, IRVINE, CA 92618
Resident Engineer: Osama Abdalla Structure Rep.: Arnel Vega

Sample Information

DIME Sample ID: 2025-10-17-44
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: 9512323690
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 10/17/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/20/2025
The quantity of what the sample constitutes: 243.82 Tons @ 19:10
A brief description of the sample: 3/4" HMA-A R25 PG64-16
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Martin Marietta — Lake Elsinore

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-33-0098
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: Belt Cut at MM-LE 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:
Sublot number:
Aggregate Mix Number: 53417195

Test Results

Test 1 of 3

DIME Test ID: 2025-10-17-44-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 11/12/2025
Date Tested: 10/21/2025
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test: Sample #1
Test Result Compliance: complies
Additional Comments When Verified:
What type of gradation is being tested? HMA Gradation
Cumulative percent passing the 2 in. sieve 100 %
Cumulative percent passing the 1 1/2 in. sieve 100 %
Cumulative percent passing the 1 in. sieve 100 %
Cumulative percent passing the 3/4 in. sieve 99 %
Cumulative percent passing the 1/2 in. sieve 88 %
Cumulative percent passing the 3/8 in. sieve 74 %
Cumulative percent passing the #4 sieve 51 %
Cumulative percent passing the #8 sieve 39 %
Cumulative percent passing the #16 sieve 28 %
Cumulative percent passing the #30 sieve 20 %
Cumulative percent passing the #50 sieve 12 %
Cumulative percent passing the #100 sieve 8 %
Cumulative percent passing the #200 sieve 5.4 %

Test 2 of 3

DIME Test ID: 2025-10-17-44-2
Test Method: AASHTO T176-08: Standard Method of Test for Plastic Fines in Graded Aggregates and Soils by Use of the Sand Equivalent Test (Sand Equivalent)
Verified Date: 11/12/2025
Date Tested: 10/21/2025
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test: Sample #1
Test Result Compliance: complies
Additional Comments When Verified:
Sand Equivalent 66

Test 3 of 3

DIME Test ID: 2025-10-17-44-3
Test Method: AASHTO T255-0: Standard Method of Test for Total Evaporable Moisture Content of Aggregate by Drying
Verified Date: 11/12/2025
Date Tested: 10/21/2025
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test: Sample #1
Test Result Compliance:
Additional Comments When Verified:
Total evaporable moisture content 2 %