DIME - Test Summary

Summary for Test 2021-01-28-26-1

Test performed: CTM 213-December 2012

Sample Taken Date	01/28/2021	Sample Unique Key	26
Date that the sample was received by the laboratory/organization performing the testing	03/04/2021	Sample type	Annual Source Testing
A brief description of the sample	1 bag Fine	The quantity of what the sample constitutes	1 bag fine
From where was the sample collected	Source	First name of sampler or witnessed by	Jeff
Last name of sampler or witnessed by	Rottos	Title of sampler	Plant QC
Telephone number of sampler		Laboratory sample identification	21-PCCF-0036
Linked DIME Sample ID		The fabricator/manufacturer/facility name	Canyon Rock
Transportation Laboratory (TL) Number	C044322	Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier		Structure name
Bid Item	Not set

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	91-49-0004::CANYON ROCK CO., INC.
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	Forrestville, CA
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		Aggregate Mix Number	Not set

DIME Sample ID: 2021-01-28-26

DIME Test ID: 2021-01-28-26-1

Testing Lab: CT HQ - Sacramento Aggregate Testing Laboratory

Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand

Test Release Date: 2021-03-24

Input Type: Measured

Tester's full name: Bang Nguyen

Date of test: 03/08/2021

Is the sample satisfactory or not?: Yes

Does debris exist: No

General comments (publicly viewable) (Max 1000 characters):

Test was verified on 3/24/2021 ✔