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Sample Record for 2024-10-23-109

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

Project Information

Project ID: 66666 DEA: APP EFIS: 0019000052 QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for Aggregate Pre-approval Program (APP). Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2024-10-23-109
TL Number from the TL Form:
Sample Submitted By Organization: Hi Grade Materials
Sample Organization Contact: (360) 269-2402
Type of Sample: Aggregate Prequalification Program
Type of Material: Aggregate
Sample Taken Date: 10/23/2024
Date that the sample was received by the laboratory/organization performing the testing: 10/23/2024
The quantity of what the sample constitutes: 200
A brief description of the sample: Washed Concrete Sand
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Hi Grade - Oro Grande

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-36-0046
The fabricator's/manufacturer's product name for the sample: WCS
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Plant Stockpile
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: fine
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:

Test Results

Test 1 of 5

DIME Test ID: 2024-10-23-109-1
Test Method: ASTM C117-17: Standard Test Method for Materials Finer than 75-μm (No. 200) Sieve in Mineral Aggregates by Washing
Verified Date: 01/17/2025
Date Tested: 10/23/2024
Submitted By Organization: Hi Grade Materials
Organization Address: 17671 Bear Valley Road,
Organization City: Hesperia
Organization State: CA
Organization Zipcode: 92345
Organization Email: pauljohnson@robar.com
Organization Phone: (760) 985-1347
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Percent finer than No. 200 sieve 0.9 %

Test 2 of 5

DIME Test ID: 2024-10-23-109-2
Test Method: ASTM C127-12: Standard Test Method for Relative Density (Specific Gravity) and Absorption of Coarse Aggregate
Verified Date: 01/17/2025
Date Tested: 10/23/2024
Submitted By Organization: Hi Grade Materials
Organization Address: 17671 Bear Valley Road,
Organization City: Hesperia
Organization State: CA
Organization Zipcode: 92345
Organization Email: pauljohnson@robar.com
Organization Phone: (760) 985-1347
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Basis for relative density testing Saturated Surface Dry
Specific Gravity 2.62
Density no data
Absorption 1.8 %

Test 3 of 5

DIME Test ID: 2024-10-23-109-3
Test Method: ASTM D3744-3: Standard Test Method for Aggregate Durability Index
Verified Date: 01/17/2025
Date Tested: 01/17/2025
Submitted By Organization: Hi Grade Materials
Organization Address: 17671 Bear Valley Road,
Organization City: Hesperia
Organization State: CA
Organization Zipcode: 92345
Organization Email: pauljohnson@robar.com
Organization Phone: (760) 985-1347
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Which test procedure(s) is/are used? Procedure B
Cumulative percent passing the No. 4 sieve 99 %
Cumulative percent passing the No. 8 sieve 86 %
Cumulative percent passing the No. 16 sieve 65 %
Cumulative percent passing the No. 30 sieve 46 %
Cumulative percent passing the No. 50 sieve 25 %
Cumulative percent passing the No. 100 sieve 8 %
Cumulative percent passing the No. 200 sieve 2.8 %
Cumulative percent in the pan no data0 %
Was strict temperature control maintained? Yes
What type of water was used? Deminerialized
Durability Index (fine) 71.0

Test 4 of 5

DIME Test ID: 2024-10-23-109-4
Test Method: ASTM D2419-09: Standard Test Method for Sand Equivalent Value of Soils and Fine Aggregate
Verified Date: 01/17/2025
Date Tested: 10/23/2024
Submitted By Organization: Hi Grade Materials
Organization Address: 17671 Bear Valley Road,
Organization City: Hesperia
Organization State: CA
Organization Zipcode: 92345
Organization Email: pauljohnson@robar.com
Organization Phone: (760) 985-1347
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sand Equivalent 89

Test 5 of 5

DIME Test ID: 2024-10-23-109-5
Test Method: ASTM C40-11: Standard Test Method for Organic Impurities in Fine Aggregates for Concrete
Verified Date: 01/17/2025
Date Tested: 10/23/2024
Submitted By Organization: Hi Grade Materials
Organization Address: 17671 Bear Valley Road,
Organization City: Hesperia
Organization State: CA
Organization Zipcode: 92345
Organization Email: pauljohnson@robar.com
Organization Phone: (760) 985-1347
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Does the fine aggregate possibly contain injurious organic impurities? No