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Sample Record for 2021-10-10-1

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

Project Information

Project ID: 209820 DEA: 04297634 EFIS: 0415000040 COOP: 042548 QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-84,680-17.9/21
Work Description: ROUTE 84 WIDENING (4-LANE EXPRESSWAY) FROM I-680 TO PIGEON PASS, INCLUDING INTERSECTION, DRAINAGE IMPROVEMENTS AND UTILITY RELOCATION.
Location Description: ALAMEDA COUNTY IN AND NEAR SUNOL, PLEASANTON, AND LIVERMORE ON ROUTE 84 FROM 0.1 MILE EAST OF ROUTE 680 TO 0.1 MILE SOUTH OF RUBY HILL DRIVE AND ON ROUTE 680 FROM 1.2 MILES SOUTH TO 1.8 MILES NORTH OF ROUTE 84
Contractor Name: Bay Cities Paving & Grading
Contractor Address: 1450 Civic Ct. BLDG B #400, Concord CA, 94520
Resident Engineer: Hung Ngo Structure Rep.: Jordan Jarosz

Sample Information

DIME Sample ID: 2021-10-10-1
TL Number from the TL Form:
Sample Submitted By Organization: Forterra
Sample Organization Contact: 916-381-3910
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 10/10/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/10/2021
The quantity of what the sample constitutes: weeks production
A brief description of the sample: sand
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert

Material Information

Source Identification (SMARA or name of Pit): 91-34-0045
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
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:

Test Results

Test 1 of 2

DIME Test ID: 2021-10-10-1-1
Test Method: ASTM C117-17: Standard Test Method for Materials Finer than 75-μm (No. 200) Sieve in Mineral Aggregates by Washing
Verified Date: 10/20/2021
Date Tested: 10/10/2021
Submitted By Organization: Forterra
Organization Address: 7020 Tokay Avenue,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95828
Organization Email: edgar.benitez@forterrabp.com
Organization Phone: 916-381-3910
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Percent finer than No. 200 sieve 2.7 %

Test 2 of 2

DIME Test ID: 2021-10-10-1-2
Test Method: ASTM D2419-09: Standard Test Method for Sand Equivalent Value of Soils and Fine Aggregate
Verified Date: 10/20/2021
Date Tested: 10/10/2021
Submitted By Organization: Forterra
Organization Address: 7020 Tokay Avenue,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95828
Organization Email: edgar.benitez@forterrabp.com
Organization Phone: 916-381-3910
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sand Equivalent 88

Tests Assigned to this Sample

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