DIME - Test Summary

Summary for Test 2022-01-31-57-1

Test performed: CTM 213-December 2012

Project Identifiers	Project ID: 215486 DEA: 040A0204 EFIS: 0400000129
DIST-CO-RTE-PM	04-SON-1-15-15.7
Award Date	05/04/2021
Closeout Date	Not set
Work Description	Construct roadway and bridge with structural concrete and CIDH piling
Location Description	District-County-Route-Post Mile: 04-Son-1-R15.0/R15.7
QA Service Level	1 (Verified on 04/08/2022)

Sample Taken Date	01/31/2022	Sample Unique Key	57
Date that the sample was received by the laboratory/organization performing the testing	04/01/2022	Sample type	Quality Assurance
A brief description of the sample	Fine Aggregate	The quantity of what the sample constitutes	1 bag
From where was the sample collected	Source	First name of sampler or witnessed by	Jeff
Last name of sampler or witnessed by	Rhodes	Title of sampler	Plant QC
Telephone number of sampler		Laboratory sample identification	22-PCCF-0057
Linked DIME Sample ID		The fabricator/manufacturer/facility name	Canyon Rock Quarry
Transportation Laboratory (TL) Number	C100504	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
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	Stock Pile
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: 2022-01-31-57

DIME Test ID: 2022-01-31-57-1

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: 2022-05-04

Input Type: Measured

Tester's full name: Bang Nguyen

Date of test: 05/03/2022

Is the sample satisfactory or not?: Yes

Does debris exist: No

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

Test was verified on 5/4/2022 ✔