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Sample Record for 2015-08-10-1

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

Project Information

Project ID: 209141 DEA: 07215954 EFIS: 0700001835 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-0.0/7.6
Work Description: WIDENING FREEWAY AND RECONSTRUCT OVERHEAD AND OVERCROSSING STRUCTURES
Location Description: LOS ANGELES COUNTY IN LA MIRADA, SANTA FE SPRINGS, NORWALK AND DOWNEY FROM ORANGE COUNTY/LOS ANGELES COUNTY LIMIT LINES TO 0.7 MILE NORTH OF ROUTE 605
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 13170 TELFAIR AVENUE, SYLMAR, CA 91342
Resident Engineer: Thang Ton Structure Rep.: Amare Tsagie

Sample Information

DIME Sample ID: 2015-08-10-1
TL Number from the TL Form: Unknown
Sample Submitted By Organization: G3 Quality, Incorporated - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 08/10/2015
Date that the sample was received by the laboratory/organization performing the testing: 08/10/2015
The quantity of what the sample constitutes: 2 bags
A brief description of the sample: rock and sand
From where was the sample collected: Source
Laboratory sample identification: Set 1
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Cemex Azusa

Material Information

Source Identification (SMARA, name of Pit or Job Site): Cemex Azusa
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Belt
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size:
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2015-08-10-1-1
Test Method: ASTM C136-06: Standard Test Method for Sieve Analysis of Fine and Coarse Aggregates
Verified Date: 10/23/2015
Date Tested: 08/11/2015
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
General Comments for this Test:
Test Result Compliance: comply
Additional Comments When Verified:
What type of gradation is being tested? 0.375 in x No. 8 - Coarse Aggregate
Cumulative percent passing the 1/2 in. sieve 100 %
Cumulative percent passing the 3/8 in. sieve 88 %
Cumulative percent passing the #4 sieve 19 %
Cumulative percent passing the #8 sieve 6 %

Test 2 of 2

DIME Test ID: 2015-08-10-1-2
Test Method: ASTM C136-06: Standard Test Method for Sieve Analysis of Fine and Coarse Aggregates
Verified Date: 10/23/2015
Date Tested: 08/11/2015
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
General Comments for this Test:
Test Result Compliance: comply
Additional Comments When Verified:
What type of gradation is being tested? Fine Aggregate
Cumulative percent passing the 3/8 in. sieve 100 %
Cumulative percent passing the #4 sieve 96 %
Cumulative percent passing the #8 sieve 78 %
Cumulative percent passing the #16 sieve 62 %
Cumulative percent passing the #30 sieve 44 %
Cumulative percent passing the #50 sieve 23 %
Cumulative percent passing the #100 sieve 10 %
Cumulative percent passing the #200 sieve 4 %