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Sample Record for 2022-02-01-15

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

Project Information

Project ID: 214951 DEA: 120K0234 EFIS: 1214000100 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-5-17.1/18.9
Work Description: South County Improvement Project (Phase 3 - El Toro/Alicia) WIDEN FREEWAY AND BRIDGES, RECONSTRUCT BRIDGE AND WALLS.
Location Description: ORANGE COUNTY IN MISSION VIEJO, LAGUNA HILLS, LAGUNA WOODS AND LAKE FOREST FROM 0.4 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING TO 0.2 MILE NORTH OF EL TORO ROAD UNDERCROSSING
Contractor Name: GUY F. ATKINSON CONSTRUCTION, LLC
Contractor Address: 18201 Von Karman Ave #800, Irvine, CA 92612
Resident Engineer: Irvin Nguyen Structure Rep.: Jason Kim

Sample Information

DIME Sample ID: 2022-02-01-15
TL Number from the TL Form:
Sample Submitted By Organization: Con-Fab California, LLC
Sample Organization Contact: (661) 630-7162
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 02/01/2022
Date that the sample was received by the laboratory/organization performing the testing: 01/31/2022
The quantity of what the sample constitutes: 1004 grams
A brief description of the sample: 3/8
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: vulcan materials

Material Information

Source Identification (SMARA, name of Pit or Job Site): SMARA 91 15 0041
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: silo
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/8 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:

Test Results

Test 1 of 1

DIME Test ID: 2022-02-01-15-1
Test Method: ASTM C117-17: Standard Test Method for Materials Finer than 75-μm (No. 200) Sieve in Mineral Aggregates by Washing
Verified Date: 02/07/2022
Date Tested: 02/01/2022
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Avenue,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: (661) 630-3281
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Percent finer than No. 200 sieve 1 %