Summary for Test 2014-11-13-3-1
Test performed: CTM 213-December 2012Project Information
| Project Identifiers | Project ID: 7463 DEA: 042640U4 EFIS: 0412000195 |
|---|---|
| DIST-CO-RTE-PM | 04-SON-101-0.9/3.6 |
| Award Date | 11/02/2012 |
| Closeout Date | 06/03/2020 |
| Work Description | CONSTRUCT PETALUMA BLVD SOUTH INTERCHANGE, REPLACE PETALUMA RIVER BR |
| Location Description | SONOMA COUNTY IN AND NEAR PETALUMA FROM GUNN DRIVE TO ROUTE 101/116 SEPARATION AND OVERHEAD |
| QA Service Level | 1 (Verified on 09/11/2012) |
Sample Information
| Sample Taken Date | 11/13/2014 | Sample Unique Key | 3 |
|---|---|---|---|
| Date that the sample was received by the laboratory/organization performing the testing | 01/23/2015 | Sample type | Annual Source Testing |
| A brief description of the sample | Concrete Blend Sand | The quantity of what the sample constitutes | 1 |
| From where was the sample collected | Source | First name of sampler or witnessed by | QC |
| Last name of sampler or witnessed by | QC | Title of sampler | QC |
| Telephone number of sampler | Unknown | Laboratory sample identification | 15FPCC-0049 |
| Linked DIME Sample ID | Unknown | The fabricator/manufacturer/facility name | Syar Lake Herman |
| Transportation Laboratory (TL) Number | C917849 | Inspector Lot Number from the Transportation Laboratory (TL) Form | |
| Structure unique identifier | Not set | Structure name | Not set |
| Bid Item | Not set |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | Syar Lake Herman |
|---|---|---|---|
| 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 Quarry |
| 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 |
Test Details
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DIME Sample ID: 2014-11-13-3
DIME Test ID: 2014-11-13-3-1
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
Test Results
Input Type: Calculated
Tester's full name: Ed Perez
Date of test: 01/28/2015
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 ✔