DIME - Test Summary

Summary for Test 2017-01-26-19-1

Test performed: CTM 213-December 2012

Project Identifiers	Project ID: 211463 DEA: 060S3504 EFIS: 0614000115
DIST-CO-RTE-PM	06-KIN,FRE-5-21.6/26.7,0/2.3,10.9/14.9
Award Date	07/20/2016
Closeout Date	03/12/2020
Work Description	CONSTRUCT HIGH TENSION CABLE MEDIAN BARRIER.
Location Description	KINGS AND FRESNO COUNTIES NEAR KETTLEMAN CITY FROM 2.6 MILES NORTH OF MILHAM AVENUE OVERCROSSING TO 3.2 MILES SOUTH OF JAYNE AVENUE OVERCROSSING AND FROM EL DORADO AVENUE OVERCROSSING TO ROUTE 5/198 SEPARATION
QA Service Level	1 (Verified on 10/04/2016)

Sample Taken Date	01/26/2017	Sample Unique Key	19
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	02/14/2017
Sample type	Annual Source Testing	A brief description of the sample	Fine PCC Aggregate
The quantity of what the sample constitutes	8 bags	From where was the sample collected	Source
First name of sampler or witnessed by	Mike	Last name of sampler or witnessed by	Holdridge
Title of sampler	TET	Telephone number of sampler	Unknown
Laboratory sample identification	17FPCC-0022	Linked DIME Sample ID	Unknown
The fabricator/manufacturer/facility name	Sierra Pacific - Avenal	Transportation Laboratory (TL) Number	C812802E
Inspector Lot Number from the Transportation Laboratory (TL) Form	Unknown	Structure unique identifier	Not set
Structure name	Not set	Bid Item	Not set

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	91-10-0006
The fabricator's/manufacturer's product name for the sample	Unknown	The fabricator/manufacturer designation for the sample	Unknown
The plant number	Unknown	A detailed description of where the material sample was collected	Stockpile
Where the material sample would have been placed if not sampled	Unknown	Primary Aggregate Nominal Size	fine
The concrete mix design number	Unknown	Lot number	Not set
Sublot number	Not set	Aggregate Mix Number	Not set

DIME Sample ID: 2017-01-26-19

DIME Test ID: 2017-01-26-19-1

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: 2017-05-05

Input Type: Calculated

Tester's full name: Benjamin Lenz

Date of test: 04/28/2017

Is the sample satisfactory or not?: Yes

Does debris exist: No

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

Test was verified on 4/28/2017 ✔