DIME - Test Summary

Summary for Test 2018-06-01-12-1

Test performed: CTM 213-December 2012

Project Identifiers	Project ID: 210794 DEA: 062HT104 EFIS: 0612000287
DIST-CO-RTE-PM	06-FRE-99-23.5/26.7
Award Date	06/30/2016
Closeout Date	09/16/2020
Work Description	(Alternative Delivery) Realign Freeway CONTACT SMR PRIOR TO PERFORMING ANY TESTING OR INSPECTION. CMGC PROJECT. Realign Route 99 between Ashlan Avenue and Olive Avenue to accommodate the High Speed Train (HST).
Location Description	State Highway 99 in Fresno (Fresno County) from 0.2 miles North of Olive Ave over-crossing to 0.2 miles North of Ashlan Ave over-crossing.
QA Service Level	1 (Verified on 10/01/2015)

Sample Taken Date	06/01/2018	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	06/18/2018
Sample type	Annual Source Testing	A brief description of the sample	Sand
The quantity of what the sample constitutes	1 bag Sand	From where was the sample collected	Source
First name of sampler or witnessed by	Heaver	Last name of sampler or witnessed by	Hudson
Title of sampler	Consultant	Telephone number of sampler	Unknown
Laboratory sample identification	Unknown	Linked DIME Sample ID	Unknown
The fabricator/manufacturer/facility name	Calaveras, Sanger	Transportation Laboratory (TL) Number	C956334
Inspector Lot Number from the Transportation Laboratory (TL) Form	Unknown	Structure unique identifier	Not set
Structure name	Not set

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	91-10-0027
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
HMA Pay	No

DIME Sample ID: 2018-06-01-12

DIME Test ID: 2018-06-01-12-1

Testing Lab: CT HQ - Sacramento Concrete Testing Laboratory

Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand

Test Release Date: 2018-07-03

Input Type: Calculated

Tester's full name: Bang Nguyen

Date of test: 07/03/2018

Is the sample satisfactory or not?: Yes

Does debris exist: No

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

Test was verified on 7/3/2018 ✔