Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993333 DEA: 04264724 EFIS: 0419000068
QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-101-R20.8/27.1
Work Description: CIP BRIDGES, CONSTRUCT ROADWAY, RETAINING WALLS AND MODIFY ELECTRICAL.
Location Description: MARIN COUNTY IN AND NEAR NOVATO FROM 0.1 MILE SOUTH OF FRANKLIN AVENUE OVERHEAD TO 0.5 MILE SOUTH OF SAN ANTONIO CREEK BRIDGE
Contractor Name: GHILOTTI CONSTRUCTION CO. INC. (RILEY GENAZZI & JOSH SERAFINO)
Contractor Address: 246 GHILOTTI AVE., SANTA ROSA, CA 95407
Resident Engineer: Fabio La Serna Structure Rep.: Jeremy Light
DIME Sample ID: 2023-02-21-58
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Petaluma Field Laboratory
Sample Organization Contact: (510) 385-6841
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 02/21/2023
Date that the sample was received by the laboratory/organization performing the testing: 02/21/2023
The quantity of what the sample constitutes: 2 boxes
A brief description of the sample: 3/4 HMA-SP Type A
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Dutra San Rafael
DIME Test ID: 2023-02-21-58-1
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Verified Date: 05/03/2023
Date Tested: 02/23/2023
Submitted By Organization: CT D04 - Petaluma Field Laboratory
Organization Address: 5675 Gibraltar Drive,
Organization City: Pleasanton
Organization State: CA
Organization Zipcode: 94588
Organization Email: glenn.cea@dot.ca.gov
Organization Phone: (510) 385-6841
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
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Number of tests
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2
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What is the unit of measurement for theoretical density?
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US 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
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7389.4 grams
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Mass of oven-dry sample in air for Sample 1
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2535.2 grams
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Mass of container filled with the sample and water for Sample 1
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8890.7 grams
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Mass of container filled with water
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7389.4
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Mass of oven-dry sample in air for Sample 2
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2540.7 grams
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Mass of container filled with the sample and water for Sample 2
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8896.2 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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2.452
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Specific Gravity for Sample 2
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2.457
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Average Specific Gravity
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2.455
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Theoretical maximum density at 25°C (77°F)
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152.8 lb/ft^3
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DIME Test ID: 2023-02-21-58-2
Test Method: AASHTO T275-07r12: Standard Method of Test for Bulk Specific Gravity (Gmb) of Compacted Asphalt Mixtures Using Paraffin-Coated Specimens (Bulk Specific Gravity)
Verified Date: 05/03/2023
Date Tested: 02/23/2023
Submitted By Organization: CT D04 - Petaluma Field Laboratory
Organization Address: 5675 Gibraltar Drive,
Organization City: Pleasanton
Organization State: CA
Organization Zipcode: 94588
Organization Email: glenn.cea@dot.ca.gov
Organization Phone: (510) 385-6841
General Comments for this Test: Core Density = 2.337 gm/cc
Test Result Compliance: complies
Additional Comments When Verified:
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Bulk Specific Gravity
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2.344
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