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

Sample Record for 2020-03-12-22


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: 2020-03-12-22
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Sample Organization Contact: (916) 227-7204
Type of Sample: Aggregate Prequalification Program
Type of Material: Aggregate
Sample Taken Date: 03/12/2020
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 4 Bags
A brief description of the sample: 1 x 4 PCC Aggregate
From where was the sample collected: Source
Laboratory sample identification: 9536
Structure unique identifier:
Structure name:

Material Information

Source Identification (SMARA or name of Pit): 91-36-0040
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Stockpile
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number:
Lot number:
Sublot number:

Test Results

Test Information 2 of 5

DIME Test ID: 2020-03-12-22-2
Test Method: CTM 211-May 2010: Abrasion of Coarse Aggregate by Use of the Los Angeles Abrasion Testing Machine
Verified Date: 06/30/2020
Date Tested: 04/21/2020
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Blvd
Test General Comments:
Additional Comments When Verified:
Grading C
Percent wear 26 %