Sample Record for 2022-03-03-20
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 215188 DEA: 080F5434 EFIS: 0817000239 Permit Numbers: 0823NMC0369
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-I-15,SR-91-6.1-7.6
Work Description: I-15 ELC: 15/91 Express Lanes Connector Project (ELC)
Location Description: Junction of I-15 and SR-91 in Corona, CA
Contractor Name: Myers-Rados Joint Venture
Contractor Address: 629 N. Main Street, Suite C3, Corona, CA 92878
Resident Engineer: Roy Fisher Structure Rep.: Alhakem Alina
Sample Information
DIME Sample ID: 2022-03-03-20
TL Number from the TL Form:
Sample Submitted By Organization: Con-Fab California, LLC
Sample Organization Contact: (661) 630-7162
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 03/03/2022
Date that the sample was received by the laboratory/organization performing the testing: 03/01/2022
The quantity of what the sample constitutes: 305
A brief description of the sample: sand
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: vulcan materials
Material Information
Source Identification (SMARA, name of Pit or Job Site): SMARA 91 15 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: silo
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 1
DIME Test ID: 2022-03-03-20-1
Test Method: ASTM C117-17: Standard Test Method for Materials Finer than 75-μm (No. 200) Sieve in Mineral Aggregates by Washing
Verified Date: 03/11/2022
Date Tested: 03/03/2022
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Avenue,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: (661) 630-3281
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Percent finer than No. 200 sieve
|
1 %
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