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Sample Record for 2025-09-03-121

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

Project Information

Project ID: 1001174 DEA: 040X7004 EFIS: 0424000158 QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-84-3.0/13.6
Work Description: COLD PLANE AC PAVEMENT AND OVERLAY WITH RHMA-G (BWC).
Location Description: SOLANO COUNTY NEAR RIO VISTA FROM 0.4 MILE NORTH OF CACHE SLOUGH FERRY TO YOLO COUNTY LINE
Contractor Name: O.C. JONES & SONS, INC.
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2025-09-03-121
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Concord Field Laboratory
Sample Organization Contact: (510) 714-7019
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 09/03/2025
Date that the sample was received by the laboratory/organization performing the testing: 09/04/2025
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4 HMA-SP-WMA
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Perkins

Material Information

Source Identification (SMARA, name of Pit or Job Site): Teichert Perkins
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: Hot Bins
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: 1
Sublot number: 1
Aggregate Mix Number:

Test Results

Test 1 of 3

DIME Test ID: 2025-09-03-121-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 02/19/2026
Date Tested: 09/04/2025
Submitted By Organization: CT D04 - Concord Field Laboratory
Organization Address: 2525 Stanwell Drive, Suite 100,
Organization City: Concord
Organization State: CA
Organization Zipcode: 94520
Organization Email: gurind.joshi@dot.ca.gov
Organization Phone: (510) 714-7019
General Comments for this Test:
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 88 %
Cumulative percent passing the 3/8 in. sieve 78 %
Cumulative percent passing the #4 sieve 44 %
Cumulative percent passing the #8 sieve 35 %
Cumulative percent passing the #16 sieve 27 %
Cumulative percent passing the #30 sieve 21 %
Cumulative percent passing the #50 sieve 14 %
Cumulative percent passing the #100 sieve 8 %
Cumulative percent passing the #200 sieve 4.3 %

Test 2 of 3

DIME Test ID: 2025-09-03-121-2
Test Method: AASHTO T30-25: Standard Method of Test for Mechanical Analysis of Extracted Aggregate (Mechanical Analysis)
Verified Date: 02/19/2026
Date Tested: 09/04/2025
Submitted By Organization: CT D04 - Concord Field Laboratory
Organization Address: 2525 Stanwell Drive, Suite 100,
Organization City: Concord
Organization State: CA
Organization Zipcode: 94520
Organization Email: gurind.joshi@dot.ca.gov
Organization Phone: (510) 714-7019
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
Is an aggregate correction factor used? No

Test 3 of 3

DIME Test ID: 2025-09-03-121-3
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: 02/19/2026
Date Tested: 09/04/2025
Submitted By Organization: CT D04 - Concord Field Laboratory
Organization Address: 2525 Stanwell Drive, Suite 100,
Organization City: Concord
Organization State: CA
Organization Zipcode: 94520
Organization Email: gurind.joshi@dot.ca.gov
Organization Phone: (510) 714-7019
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Sand Equivalent 82