Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001999 DEA: 044X5604 EFIS: 0426000094
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-680-M0.01/M0.01
Work Description:
Location Description:
Contractor Name: Case Pacific
Contractor Address: 2121 Ardmore Road, Paso Robles, CA 93446
Resident Engineer: Reza Kamkar Structure Rep.: Unknown
DIME Sample ID: 2026-08-11-25
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Pleasanton Field Laboratory
Sample Organization Contact: (510) 224-6127
Type of Sample: Production Start-Up
Type of Material: Aggregate
Sample Taken Date: 08/11/2026
Date that the sample was received by the laboratory/organization performing the testing: 08/12/2026
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4"HMA w/25% RAP
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Pleasanton Plant
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:
DIME Test ID: 2026-08-11-25-1
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: 08/26/2026
Date Tested: 08/17/2026
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: 3 SE's and its average
Test Result Compliance: complies
Additional Comments When Verified:
