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Sample Record for 2013-10-24-9004884

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

Project Information

Project ID: 5266 DEA: 08448404 EFIS: 0800000712 COOP: 081488A1 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-91-15.6/21.6
Work Description: CONSTRUCT HOV LANES AND WIDEN BRIDGES.
Location Description: RIVERSIDE COUNTY IN RIVERSIDE FROM ADAMS STREET TO THE ROUTE 60/215 SEPARATION
Contractor Name: SEMA CONSTRUCTION INC
Contractor Address: 320 Goddard, Suite 150, , Irvine, CA 92618
Resident Engineer: Joseph Lopez Structure Rep.: Alina, Al-Hakem

Sample Information

DIME Sample ID: 2013-10-24-9004884
TL Number from the TL Form:
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 10/24/2013
Date that the sample was received by the laboratory/organization performing the testing: 10/24/2013
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: Class 2 Aggregate Subbase
From where was the sample collected: Other
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Unknown

Material Information

Source Identification (SMARA or name of Pit): NA
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: Sta. 334 00 WB 91
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size:
The concrete mix design number:
Lot number:
Sublot number:

Test Results

Test Information 2 of 3

DIME Test ID: 2013-10-24-9004884-2
Test Method: CTM 217-June 2011: Method of Test for Sand Equivalent
Verified Date: 02/20/2015
Date Tested: 10/29/2013
Submitted By Organization: CT - Southern Regional Laboratory
Organization Address: 13970 Victoria St,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 213-792-4794
General Comments for this Test:
Additional Comments When Verified:
Number of tests 1
Sand equivalent after temperature correction 27

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.