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Sample Record for 2019-03-01-5

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

Project Information

Project ID: 88888 DEA: SMTL-STOCK EFIS: SMTL-STOCK QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for SMTL stock material. 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: 2019-03-01-5
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Cement Testing Laboratory
Sample Organization Contact: (916) 227-7071
Type of Sample: Preliminary
Type of Material: Cementitious
Sample Taken Date: 03/01/2019
Date that the sample was received by the laboratory/organization performing the testing: 03/01/2019
The quantity of what the sample constitutes: 1 Bucket
A brief description of the sample: Class N Pozzolan
From where was the sample collected: Source
Laboratory sample identification: CM192903
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Geofortis

Material Information

Brand: Geofortis
Mill: 45 45 10 Blend
Type of Cementitious Material: Class F or N Flyash
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2019-03-01-5-4
Test Method: ASTM C430-8: Standard Test Method for Fineness of Hydraulic Cement by the 45-μm (No. 325) Sieve
Submitted By Organization: CT HQ - Sacramento Cement Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: ben.lenz@dot.ca.gov
Organization Phone: (916) 227-7071
Data has not been verified.

Test 2 of 3

DIME Test ID: 2019-03-01-5-6
Test Method: ASTM C109-16a: Standard Test Method for Compressive Strength of Hydraulic Cement Mortars (Using 2-in. or [50-mm] Cube Specimens)
Submitted By Organization: CT HQ - Sacramento Cement Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: ben.lenz@dot.ca.gov
Organization Phone: (916) 227-7071
Data has not been verified.

Test 3 of 3

DIME Test ID: 2019-03-01-5-7
Test Method: ASTM C109-16a: Standard Test Method for Compressive Strength of Hydraulic Cement Mortars (Using 2-in. or [50-mm] Cube Specimens)
Submitted By Organization: CT HQ - Sacramento Cement Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: ben.lenz@dot.ca.gov
Organization Phone: (916) 227-7071
Data has not been verified.