Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000567 DEA: 042K7404 EFIS: 0417000018
QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-37-R11.2/14.5
Work Description: COLD PLANE AC PVMT, PLACE RHMA AND REPLACE CONCRETE BARRIER.
Location Description: MARIN COUNTY IN AND NEAR NOVATO FROM IGNACIO OVERHEAD TO PETALUMA RIVER BRIDGE
Contractor Name: BAY CITIES PAVING & GRADING, INC.
Contractor Address: 1450 Civic Street, Concord, CA 94520
Resident Engineer: Christopher Prokop Structure Rep.: Jeremy Light
DIME Sample ID: 2025-10-27-59
TL Number from the TL Form: 2026-01-20-01
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: Hot Mix Asphalt
Sample Taken Date: 10/27/2025
Date that the sample was received by the laboratory/organization performing the testing: 01/23/2026
The quantity of what the sample constitutes: 20 Boxes RHMA
A brief description of the sample: 1/2" RHMA-G
From where was the sample collected: Manufacturer
Laboratory sample identification: D04-SE-26-002
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Materials LH (DP)
DIME Test ID: 2025-10-27-59-1
Test Method: AASHTO T209-22: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Verified Date: 03/22/2026
Date Tested: 01/23/2026
Submitted By Organization: CT D04 - Richmond Field Laboratory
Organization Address: 3401 Regatta Boulevard,
Organization City: Richmond
Organization State: CA
Organization Zipcode: 94508
Organization Email: santiago.sequeira@dot.ca.gov
Organization Phone: (510) 385-7641
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
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Number of Samples
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1
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What is the unit of measurement for theoretical density?
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SI Units
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Mass Determination
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Air
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Method Performed
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Mechanical Agitation - Method A
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Mass of container filled with water 1
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7379.8 grams
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Mass of oven-dry sample in air for Sample 1
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1544 grams
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Mass of container filled with the sample and water for Sample 1
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8292.1 grams
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Temperature of Water
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77 °F
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Specific Gravity for Sample 1
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2.444
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Theoretical maximum density at 25°C (77°F)
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2437 kg/m^3
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