Summary for Test 2018-01-08-13-1

Test performed: CTM 213-December 2012

Project Information

Project IdentifiersProject ID: 211875
DEA: 040J6404
EFIS: 0414000021
DIST-CO-RTE-PM04-SON-101-29.3/R43.4
Award Date03/03/2017
Closeout Date06/21/2019
Work DescriptionRESURFACE AND RESTORE PAVEMENT FOR MAINLINE AND RAMPS
Location DescriptionSONOMA COUNTY IN AND NEAR WINDSOR AND HEALDSBURG FROM WINDSOR LANE UNDERCROSSING TO ROUTE 101/128 SEPARATION
QA Service Level1 (Verified on 04/18/2017)

Sample Information

Sample Taken Date01/08/2018 Sample Unique Key13
Date that the sample was received by the laboratory/organization performing the testing04/23/2018 Sample typeAnnual Source Testing
A brief description of the sampleFine PCC Aggregate The quantity of what the sample constitutes1 bag
From where was the sample collectedSource First name of sampler or witnessed byJ
Last name of sampler or witnessed byNixa Title of samplerUnknown
Telephone number of samplerUnknown Laboratory sample identification18-0084
Linked DIME Sample IDUnknown The fabricator/manufacturer/facility nameSyar Healdsburg
Transportation Laboratory (TL) NumberC874188 Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown
Structure unique identifierNot set Structure nameNot set
Bid ItemNot set

Material Information

Material TypeAggregate 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 sampleUnknown The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedStockpile Quarry
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Sizefine
The concrete mix design numberUnknown Lot numberNot set
Sublot numberNot set Aggregate Mix NumberNot set
HMA PayNo

Test Details

DIME Sample ID: 2018-01-08-13
DIME Test ID: 2018-01-08-13-1
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: 2018-05-29

Test Results


Input Type: Calculated
Tester's full name: Phillip Montes
Date of test: 05/29/2018
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 5/29/2018 ✔