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Sample Record for 2023-02-21-35

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

Project Information

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

Sample Information

DIME Sample ID: 2023-02-21-35
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: Aggregate
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 bags
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

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-21-0008
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: Conveyor Belt
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: 3
Sublot number: 1
Aggregate Mix Number: DO4 JMF 22 025

Test Results

Test 1 of 2

DIME Test ID: 2023-02-21-35-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 05/03/2023
Date Tested: 02/22/2023
Submitted By Organization: CT D04 - Petaluma Field Laboratory
Organization Address: 5675 Gibraltar Dr.,
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:
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 97 %
Cumulative percent passing the 1/2 in. sieve 91 %
Cumulative percent passing the 3/8 in. sieve 77 %
Cumulative percent passing the #4 sieve 47 %
Cumulative percent passing the #8 sieve 28 %
Cumulative percent passing the #16 sieve 16 %
Cumulative percent passing the #30 sieve 11 %
Cumulative percent passing the #50 sieve 8 %
Cumulative percent passing the #100 sieve 6 %
Cumulative percent passing the #200 sieve 4.8 %

Test 2 of 2

DIME Test ID: 2023-02-21-35-2
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: 05/03/2023
Date Tested: 02/22/2023
Submitted By Organization: CT D04 - Petaluma Field Laboratory
Organization Address: 5675 Gibraltar Dr.,
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:
Sand Equivalent 54