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Sample Record for 2021-04-09-22

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

Project Information

Project ID: 8801 DEA: AML-CEM EFIS: AML-CEM QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for Cementitious Materials for use in Concrete Authorized Material List (AML)
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-04-09-22
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: Annual Source Testing
Type of Material: Cementitious
Sample Taken Date: 04/09/2021
Date that the sample was received by the laboratory/organization performing the testing: 04/09/2021
The quantity of what the sample constitutes: 1 Bucket
A brief description of the sample: Fly Ash
From where was the sample collected: Source
Laboratory sample identification: CM215190
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Golden State Pozzolan

Material Information

Brand: Golden State Pozzolan
Mill: GSP Class N Pozzolan
Type of Cementitious Material: Class F or N Flyash

Test Results

Test 1 of 3

DIME Test ID: 2021-04-09-22-2
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 Blvd,
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: 2021-04-09-22-3
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 Blvd,
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: 2021-04-09-22-4
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 Blvd,
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.

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.