Project Information

Project ID: 1000274 DEA: 041X2804 EFIS: 0424000295 QA Service Level: 1

DIST-CO-RTE-PM: 04-ALA-84-11.2 or 15.5

Work Description: Repair Slip Out

Location Description: Niles Canyon

Contractor Name: Pacific Coast Drilling Co., Inc. (Aaron Sykes)

Contractor Address: 364 Bellevue Ave., Santa Rosa 95407

Resident Engineer: Eddie Dike Structure Rep.: Jordan Jarosz

Sample Information

DIME Sample ID: 2025-11-08-17

TL Number from the TL Form:

Sample Submitted By Organization: CT D04 - Pleasanton Field Laboratory

Sample Organization Contact: (510) 224-6127

Type of Sample: Quality Assurance

Type of Material: Aggregate

Sample Taken Date: 11/08/2025

Date that the sample was received by the laboratory/organization performing the testing: 11/10/2025

The quantity of what the sample constitutes: 750 Tons

A brief description of the sample: 3/4-inch HMA-SP Type A

From where was the sample collected: Source

Laboratory sample identification:

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: Vulcan Pleasanton

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-01-0010

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: Plant Sampler

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: 220304

Test Results

Test 1 of 2

DIME Test ID: 2025-11-08-17-1

Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)

Verified Date: 11/18/2025

Date Tested: 11/17/2025

Submitted By Organization: CT D04 - Pleasanton Field Laboratory

Organization Address: 5675 B Gibratar Drive,

Organization City: Pleasanton

Organization State: CA

Organization Zipcode: 94588

Organization Email: dennis.yeung@dot.ca.gov

Organization Phone: (510) 224-6127

General Comments for this Test: Sample #1

Test Result Compliance: complies

Additional Comments When Verified:

What type of gradation is being tested?	Combined 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	84 %
Cumulative percent passing the 3/8 in. sieve	71 %
Cumulative percent passing the #4 sieve	47 %
Cumulative percent passing the #8 sieve	27 %
Cumulative percent passing the #16 sieve	18 %
Cumulative percent passing the #30 sieve	14 %
Cumulative percent passing the #50 sieve	9 %
Cumulative percent passing the #100 sieve	6 %
Cumulative percent passing the #200 sieve	4 %

Test 2 of 2

DIME Test ID: 2025-11-08-17-2

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)