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Sample Record for 2023-11-01-1

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

Project Information

Project ID: 994554 DEA: 032G7304 EFIS: 0322000152 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-5-0.0/3.6
Work Description: REPLACE CONCRETE SLABS WITH INDIVIDUAL PRECAST CONCRETE SLABS.
Location Description: SACRAMENTO COUNTY NEAR MOKELUMNE CITY FROM SACRAMENTO COUNTY LINE TO 0.5 MILE NORTH OF DIERSSEN ROAD OVERCROSSING
Contractor Name: MYERS & SONS CONSTRUCTION, LLC
Contractor Address: 45 Morrison Ave, Sacramento, CA 95838
Resident Engineer: Ephrem Teweldeberhan Structure Rep.: Luis Pompa

Sample Information

DIME Sample ID: 2023-11-01-1
TL Number from the TL Form:
Sample Submitted By Organization: Con-Fab California Corporation - Lathrop
Sample Organization Contact: (209) 249-4700
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 11/01/2023
Date that the sample was received by the laboratory/organization performing the testing: 11/01/2023
The quantity of what the sample constitutes: 1 Bucket of 1/2", 1 Bucket of 3/8", One Bucket of Sand
A brief description of the sample: 1 bucket of 1/2", 3/8" and Sand
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: ConFab Lathrop

Material Information

Source Identification (SMARA, name of Pit or Job Site): 11-01-2023
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: Stockpile @ 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:
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2023-11-01-1-1
Test Method: ASTM C566-13: Standard Test Method for Total Evaporable Moisture Content of Aggregate by Drying
Verified Date: 11/06/2023
Date Tested: 10/30/2023
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 Lathrop Road,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email: dannyc@confabca.com
Organization Phone: (209) 249-4717
General Comments for this Test: Rocks: 0.40% Sand: 3.25 %
Test Result Compliance:
Additional Comments When Verified:
Total evaporable moisture content 0.4 %