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Sample Record for 2018-04-26-4

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

Project Information

Project ID: 210808 DEA: 020E0904 EFIS: 0200000016 QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-5-R29.3/R31.1,R45.0/R45.8
Work Description: REPLACE BRIDGE, REALIGN ROADWAY AND SEISMIC RETROFIT
Location Description: IN SHASTA COUNTY ABT 8 MI N OF SHASTA LAKE CTY AND NEAR LAKEHEAD FRM TURNTABLE BAY O/C TO 0.1 MI N OF O'BRIEN SRRA & FRM 0.4 MI S TO 0.3 MI N OF DOG CREEK BRIDGE.
Contractor Name: GOLDEN STATE BRIDGE, INC.
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Nathan Alexander Structure Rep.: Christopher S 'Chris' Brace

Sample Information

DIME Sample ID: 2018-04-26-4
TL Number from the TL Form: C571799
Sample Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Sample Organization Contact: (916) 227-7204
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 04/26/2018
Date that the sample was received by the laboratory/organization performing the testing: 05/01/2018
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: Lightweight Aggregate
From where was the sample collected: Distributor
Laboratory sample identification: 18-0076
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Utelite

Material Information

Source Identification (SMARA, name of Pit or Job Site): NA
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: Stockpile
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number: Unknown
Lot number:
Sublot number:
Aggregate Mix Number:

Test Results

Test 1 of 1

DIME Test ID: 2018-04-26-4-2
Test Method: AASHTO T104-99r16: Standard Method of Test for Soundness of Aggregate by Use of Sodium Sulfate or Magnesium Sulfate (Soundness)
Verified Date: 05/24/2018
Date Tested: 05/24/2018
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bang.d.nguyen@dot.ca.gov
Organization Phone: (916) 227-7204
General Comments for this Test:
Test Result Compliance: does not comply
Additional Comments When Verified:
Size of aggregate being tested Coarse Aggregate
What type of solution was used? Sodium sulfate
What was the condition of the solution? Previously used
Number of immersion cycles performed 5
Coarse weighted average loss 17.5 %