DIME - Test Summary

Summary for Test 2019-12-31-4-1

Test performed: CTM 202-November 2011

Project Identifiers	Project ID: 210735 DEA: 071193U4 EFIS: 0713000007
DIST-CO-RTE-PM	07-LA-10-37.2/42.4
Award Date	11/16/2015
Closeout Date	07/11/2022
Work Description	CONSTRUCT HOV LANES, WIDEN BRIDGES, AND REALIGN RAMPS.
Location Description	IN LA COUNTY FROM CITRUS STREET IN WEST COVINA TO ROUTE 57 IN POMONA
QA Service Level	1 (Verified on 03/07/2016)

Sample Taken Date	12/31/2019	Sample Unique Key	4
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	01/02/2020
Sample type	Department Acceptance	A brief description of the sample	1" AGGREGATE PCC
The quantity of what the sample constitutes	1 BAG	From where was the sample collected	Source
First name of sampler or witnessed by	HORNESTO	Last name of sampler or witnessed by	Castillo
Title of sampler	MREA	Telephone number of sampler
Laboratory sample identification	9078	Linked DIME Sample ID	2019-12-31-4
The fabricator/manufacturer/facility name	HOLIDAY ROCK upland	Transportation Laboratory (TL) Number	C915129
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name		Bid Item	Not set

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	Unknown
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	Unknown
Where the material sample would have been placed if not sampled	STG 5 VIA VERDE BRIDGE	Primary Aggregate Nominal Size	1 inch
The concrete mix design number	Unknown	Lot number	Unknown
Sublot number	Unknown	Aggregate Mix Number	Not set

DIME Sample ID: 2019-12-31-4

DIME Test ID: 2019-12-31-4-1

Testing Lab: CT D08 - Fontana Southern Regional Laboratory

Test Method: CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates

Test Release Date: 2020-03-19

What size aggregate is being tested?: 1 in. x No. 4 - Coarse Aggregate

Individual or cumulative mass retained on each sieve?: Cumulative Mass Retained

For Combined Gradation only, has the fine aggregate sample been reduced?: No

For Combined Gradation only, use #40 Sieve?: No

Input Type: Calculated

Tester's full name: EDMOUND JABBOUR

Date of test: 01/03/2020

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

Test was verified on 3/19/2020 ✔