Summary for Test 2021-01-05-24-1
Test performed: CTM 213-December 2012Project Information
| Project Identifiers | Project ID: 214601 DEA: 041J5694 EFIS: 0419000313 |
|---|---|
| DIST-CO-RTE-PM | 04-SM-101-0.0/21.8 |
| Award Date | 12/03/2019 |
| Closeout Date | 09/28/2022 |
| Work Description | San Mateo US 101 Express Lanes North |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 04/08/2022) |
Sample Information
| Sample Taken Date | 01/05/2021 | Sample Unique Key | 24 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | Yes | Date that the sample was received by the laboratory/organization performing the testing | 04/01/2021 |
| Sample type | Annual Source Testing | A brief description of the sample | concrete sand |
| The quantity of what the sample constitutes | 1 bag | From where was the sample collected | Source |
| First name of sampler or witnessed by | L | Last name of sampler or witnessed by | Magena |
| Title of sampler | Consultant | Telephone number of sampler | |
| Laboratory sample identification | 21-PCCF-0056 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Orca Sand Hanson | Transportation Laboratory (TL) Number | C924560 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Bid Item | Not set |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 07-008-013 |
|---|---|---|---|
| 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 | Aggregate Mix Number | Not set |
Test Details
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DIME Sample ID: 2021-01-05-24
DIME Test ID: 2021-01-05-24-1
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: 2021-04-16
Test Results
Input Type: Measured
Tester's full name: Ryan Kester
Date of test: 04/05/2021
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):
Test was verified on 4/16/2021 ✔