DIME - Test Summary

Summary for Test 2015-01-07-2-1

Test performed: CTM 213-December 2012

Sample Taken Date	01/07/2015	Sample Unique Key	2
Date that the sample was received by the laboratory/organization performing the testing	01/07/2015	Sample type	Annual Source Testing
A brief description of the sample	Blend Sand	The quantity of what the sample constitutes	1 Bag
From where was the sample collected	Other	First name of sampler or witnessed by	Richard
Last name of sampler or witnessed by	Duncan	Title of sampler	Unknown
Telephone number of sampler	Unknown	Laboratory sample identification	15Fpcc-0021
Linked DIME Sample ID	Unknown	The fabricator/manufacturer/facility name	Syar Healdsburg
Transportation Laboratory (TL) Number	C917832	Inspector Lot Number from the Transportation Laboratory (TL) Form
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)	91-49-0062 and 91-49-004
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
The concrete mix design number		Lot number	Not set
Sublot number	Not set	Aggregate Mix Number	Not set

DIME Sample ID: 2015-01-07-2

DIME Test ID: 2015-01-07-2-1

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: 2015-01-29

Input Type: Calculated

Tester's full name: Thomas Stinnett

Date of test: 01/07/2015

Is the sample satisfactory or not?: Yes

Does debris exist: No

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

Test was verified on 1/29/2015 ✔