Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993239 DEA: 100P5404 EFIS: 1013000251
QA Service Level: 1
DIST-CO-RTE-PM: 10-SJ,STA-5,99-6.2/6.6,R17.7/R18.1
Work Description: REMOVE & PLACE STRUCTURAL CONCRETE BRIDGE; AND PLACE CONCRETE BARRIER.
Location Description: SAN JOAQUIN AND STANISLAUS COUNTIES ON ROUTE 5 FROM 0.2 MILE SOUTH TO 0.2 MILE NORTH OF ROUTE 5/33 SEPARATION AND OVERHEAD AND ON ROUTE 99 FROM 0.2 MILE SOUTH TO 0.2 MILE NORTH OF WEST MODESTO OVERHEAD
Contractor Name: Bridgeway Civil Constructors, Inc. - Tomas Ramirez
Contractor Address: 3333 Vaca Valley Parkway, Suite 200, Vacaville, CA 95219
Resident Engineer: Ariel Mendoza Structure Rep.: Ron Matin
DIME Sample ID: 2022-05-12-44
TL Number from the TL Form:
Sample Submitted By Organization: CT D10 - District 10 Materials Laboratory
Sample Organization Contact: (209) 948-7567
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 05/12/2022
Date that the sample was received by the laboratory/organization performing the testing: 05/13/2022
The quantity of what the sample constitutes: 2 boxs
A brief description of the sample: HMA
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Vernalis
DIME Test ID: 2022-05-12-44-1
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: 04/19/2023
Date Tested: 05/24/2022
Submitted By Organization: CT D10 - District 10 Materials Laboratory
Organization Address: 1976 East Dr. Martin Luther King Jr. Boulevard,
Organization City: Stockton
Organization State: CA
Organization Zipcode: 95205
Organization Email: mandeep.dhesi@dot.ca.gov
Organization Phone: (209) 948-7567
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of tests
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1
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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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Water
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Specific Gravity for Sample 1
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2.500
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Theoretical maximum density at 25°C (77°F)
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155.6 lb/ft^3
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