Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001288 DEA: 041X1004 EFIS: 0424000249
QA Service Level: 1
DIST-CO-RTE-PM: 04-SCL-9-4.0
Work Description:
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Gene Earl Malonzo Structure Rep.: Unknown
DIME Sample ID: 2025-07-21-78
TL Number from the TL Form: SJ-072125-2
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: 07/21/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/30/2025
The quantity of what the sample constitutes: 4 bags Aggregate
A brief description of the sample: 1/2" HMA-A+15% RAP
From where was the sample collected: Manufacturer
Laboratory sample identification: D04-SE-25-076
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Peninsula Road Materials-RC
Source Identification (SMARA, name of Pit or Job Site): 91-35-0012
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: Conveyer Belt-HMA Plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number: 373
DIME Test ID: 2025-07-21-78-1
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.
DIME Test ID: 2025-07-21-78-2
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.
DIME Test ID: 2025-07-21-78-3
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.
DIME Test ID: 2025-07-21-78-4
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.
