Project Information

Project ID: 994120 DEA: 040J6314 EFIS: 0421000252 QA Service Level: 1

DIST-CO-RTE-PM: 04-SOL-12-21.2/22.6

Work Description: ROADWAY RESURFACING, INSTALL DRAINAGE SYSTEM, MIDWEST GUARDRAIL SYSTEM

Location Description: SOLANO COUNTY NEAR RIO VISTA FROM MCCLOSKY ROAD TO 0.1 MILE WEST OF AZEVEDO ROAD

Contractor Name: Bay Cities Paving & Grading (David Jimenez)

Contractor Address: 1450 Civic Ct. BLDG B #400, Concord CA, 94520

Resident Engineer: Noel Aquino Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2023-08-11-60

TL Number from the TL Form:

Sample Submitted By Organization: CT D04 - Concord Field Laboratory

Sample Organization Contact: (510) 714-7019

Type of Sample: Quality Assurance

Type of Material: Aggregate

Sample Taken Date: 08/11/2023

Date that the sample was received by the laboratory/organization performing the testing: 08/11/2023

The quantity of what the sample constitutes: LOT 1 SUBLOT 1

A brief description of the sample: 1/2-INCH HMA-SP Type A

From where was the sample collected: Source

Laboratory sample identification:

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: Teichert Vernails Plant Production Startup

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-39-0041

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: Sample Pickup From Plant

Where the material sample would have been placed if not sampled:

Primary Aggregate Nominal Size: 1/2 inch

The concrete mix design number:

Lot number:

Sublot number:

Aggregate Mix Number: 30240442412V

Test Results

Test 1 of 2

DIME Test ID: 2023-08-11-60-1

Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)

Verified Date: 09/13/2023

Date Tested: 08/11/2023

Submitted By Organization: CT D04 - Concord Field Laboratory

Organization Address: 2525 Stanwell Drive, Suite 100,

Organization City: Concord

Organization State: CA

Organization Zipcode: 94520

Organization Email: gurind.joshi@dot.ca.gov

Organization Phone: (510) 714-7019

General Comments for this Test: LOT 1 SUBLOT 1 Teichert Vernalis Plant Production Startup Passed 12%RAP

Test Result Compliance: complies

Additional Comments When Verified:

What type of gradation is being tested?	Combined Gradation
Cumulative percent passing the 2 in. sieve	0 %
Cumulative percent passing the 1 1/2 in. sieve	0 %
Cumulative percent passing the 1 in. sieve	100 %
Cumulative percent passing the 3/4 in. sieve	100 %
Cumulative percent passing the 1/2 in. sieve	96 %
Cumulative percent passing the 3/8 in. sieve	82 %
Cumulative percent passing the #4 sieve	55 %
Cumulative percent passing the #8 sieve	41 %
Cumulative percent passing the #16 sieve	27 %
Cumulative percent passing the #30 sieve	16 %
Cumulative percent passing the #50 sieve	9 %
Cumulative percent passing the #100 sieve	6 %
Cumulative percent passing the #200 sieve	3.6 %

Test 2 of 2

DIME Test ID: 2023-08-11-60-2

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)