DIME - Test Summary

Summary for Test 2023-03-13-35-1

Test performed: CTM 213-December 2012

Project Identifiers	Project ID: 214986 DEA: 041J9704 EFIS: 0414000404
DIST-CO-RTE-PM	04-SCL-17-2.8/13.94
Award Date	04/30/2021
Closeout Date	10/06/2025
Work Description	PAVING WITH RHMA, COLD PLANE AC, AND INSTALL CULVERT.
Location Description	SANTA CLARA COUNTY IN AND NEAR LOS GATOS, CAMPBELL AND SAN JOSE FROM HEBARD ROAD TO ROUTE 17/280 SEPARATION
QA Service Level	1 (Verified on 10/19/2020)

Sample Taken Date	03/13/2023	Sample Unique Key	35
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	05/25/2023
Sample type	Annual Source Testing	A brief description of the sample	Fine Aggregate
The quantity of what the sample constitutes	1 bag fine aggregate	From where was the sample collected	Source
First name of sampler or witnessed by	Fernando	Last name of sampler or witnessed by	Vega
Title of sampler	MREA	Telephone number of sampler
Laboratory sample identification	23-ASF-0094	Linked DIME Sample ID
The fabricator/manufacturer/facility name	Granite Rock Aromas	Transportation Laboratory (TL) Number	C927722
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)	91-35-0012
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

DIME Sample ID: 2023-03-13-35

DIME Test ID: 2023-03-13-35-1

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: 2023-06-27

Input Type: Measured

Tester's full name: Bang Nguyen

Date of test: 06/23/2023

Is the sample satisfactory or not?: Yes

Does debris exist: No

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

Test was verified on 6/27/2023 ✔