*Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Sample Record for 2019-03-08-19


Project Information

Project ID: 66666 DEA: APP EFIS: 0019000052 QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for Aggregate Pre-approval Program (APP). Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Contractor Address:
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-03-08-19
TL Number from the TL Form:
Sample Submitted By Organization: Vulcan Materials Company - Irwindale
Sample Organization Contact: 323-833-8388
Type of Sample: Aggregate Prequalification Program
Type of Material: Aggregate
Sample Taken Date: 03/08/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 160 lbs
A brief description of the sample: Washed 3/8 Crushed Rock
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

Source Identification (SMARA or name of Pit): 91-19-0035::FISH CANYON QUARRY
The fabricator's/manufacturer's product name for the sample: Washed 3/8 Crushed Rock
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Stockpile @ Plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/8 inch
The concrete mix design number:
Lot number:
Sublot number:

Test Results

Test Information 4 of 4

DIME Test ID: 2019-03-08-19-4
Test Method: CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)
Verified Date: 10/01/2019
Date Tested: 03/09/2019
Submitted By Organization: Vulcan Materials Company - Irwindale
Organization Address: 16005 Foothill Boulevard
Test General Comments:
Additional Comments When Verified:
Cleanness value (11/2 in. maximum aggregate mix) 86