Summary for Test 2016-11-07-12-1
Test performed: CTM 213-December 2012Project Information
| Project Identifiers | Project ID: 209060 DEA: 041A2904 EFIS: 0400000482 |
|---|---|
| DIST-CO-RTE-PM | 04-SON-12-9.6 |
| Award Date | 03/11/2014 |
| Closeout Date | 01/10/2019 |
| Work Description | REPLACE BRIDGE AND WIDEN APPROACHES. |
| Location Description | SONOMA COUNTY NEAR THE CITY OF SEBASTOPOL AT LAGUNA DE SANTA ROSA BRIDGE |
| QA Service Level | 1 (Verified on 01/23/2014) |
Sample Information
| Sample Taken Date | 11/07/2016 | Sample Unique Key | 12 |
|---|---|---|---|
| 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 | 03/03/2017 |
| Sample type | Annual Source Testing | A brief description of the sample | Fine PCC Aggregate |
| The quantity of what the sample constitutes | 5 bags | From where was the sample collected | Source |
| First name of sampler or witnessed by | Plant | Last name of sampler or witnessed by | Personnel |
| Title of sampler | Unknown | Telephone number of sampler | Unknown |
| Laboratory sample identification | 17CPCC-0139 | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | Syar Healdsburg | Transportation Laboratory (TL) Number | C918644 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | Not set |
| Structure name | Not set | Bid Item | Not set |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-49-0062::HEALDSBURG TERRACE PHASE VI |
|---|---|---|---|
| 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 @ Plant |
| 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 |
Test Details
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DIME Sample ID: 2016-11-07-12
DIME Test ID: 2016-11-07-12-1
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: 2017-06-22
Test Results
Input Type: Calculated
Tester's full name: Phillip Montes
Date of test: 06/22/2017
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):
Test was verified on 6/22/2017 ✔