DIME - Test Summary

Summary for Test 2019-12-12-32-1

Test performed: CTM 213-December 2012

Sample Taken Date	12/12/2019	Sample Unique Key	32
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	02/14/2020
Sample type	Annual Source Testing	A brief description of the sample	PCC Sand
The quantity of what the sample constitutes	3 Bags	From where was the sample collected	Source
First name of sampler or witnessed by	Casey	Last name of sampler or witnessed by	Farrington
Title of sampler		Telephone number of sampler
Laboratory sample identification	20-PCCF-0031	Linked DIME Sample ID
The fabricator/manufacturer/facility name	Mark West Quarry	Transportation Laboratory (TL) Number	C918161
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	91-49-0032::MARK WEST QUARRY
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	Unknown
Sublot number	Unknown	Aggregate Mix Number	Not set

DIME Sample ID: 2019-12-12-32

DIME Test ID: 2019-12-12-32-1

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: 2020-04-17

Input Type: Measured

Tester's full name: Ryan Kester

Date of test: 04/17/2020

Is the sample satisfactory or not?: Yes

Does debris exist: No

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

Test was verified on 4/17/2020 ✔