DIME - Test Summary

Summary for Test 2018-02-01-14-1

Test performed: CTM 213-December 2012

Project Identifiers	Project ID: 212952 DEA: 060S4904 EFIS: 0615000050
DIST-CO-RTE-PM	06-KIN-5-0.0/9.0
Award Date	02/22/2018
Closeout Date	10/25/2019
Work Description	REPLACE FAILED CONCRETE SLAB PANELS AND RESURFACE WITH HMA.
Location Description	KINGS COUNTY NEAR LOST HILLS FROM KERN COUNTY LINE TO 0.9 MILE SOUTH OF EQUIPMENT UNDERCROSSING
QA Service Level	1 (Verified on 05/15/2018)

Sample Taken Date	02/01/2018	Sample Unique Key	14
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	04/03/2018
Sample type	Annual Source Testing	A brief description of the sample	Sand
The quantity of what the sample constitutes	1 bag	From where was the sample collected	Source
First name of sampler or witnessed by	D	Last name of sampler or witnessed by	Ruff
Title of sampler	Unknown	Telephone number of sampler	Unknown
Laboratory sample identification	18-0071	Linked DIME Sample ID	Unknown
The fabricator/manufacturer/facility name	Granite Coalinga	Transportation Laboratory (TL) Number	C813413D
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)	91-10-0005::COALINGA PIT #1
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
HMA Pay	No

DIME Sample ID: 2018-02-01-14

DIME Test ID: 2018-02-01-14-1

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: 2018-04-27

Input Type: Calculated

Tester's full name: Phillip Montes

Date of test: 04/27/2018

Is the sample satisfactory or not?: Yes

Does debris exist: No

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

Test was verified on 4/27/2018 ✔