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Sample Record for 2014-03-20-11077038

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

Project Information

Project ID: 6842 DEA: 04264144 EFIS: 0400002023 QA Service Level: 1
DIST-CO-RTE-PM: 04-NAP,SOL-12-2.8/3.3,0.0/2.6
Work Description: WIDEN ROUTE 12 FROM A TWO-LANE TO A FOUR-LANE CONVENTIONAL HIGHWAY
Location Description: NAPA AND SOLANO COUNTIES FROM 0.5 MILE WEST OF NAPA COUNTY LINE TO RED TOP ROAD
Contractor Name: GHILOTTI CONSTRUCTION COMPANY
Contractor Address: 246 GHILOTTI AVENUE, SANTA ROSA, CA 95407
Resident Engineer: Elias Moussa Structure Rep.: Roman, Robert

Sample Information

DIME Sample ID: 2014-03-20-11077038
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: Per Request
Type of Material: Aggregate
Sample Taken Date: 03/20/2014
Date that the sample was received by the laboratory/organization performing the testing: 03/03/2014
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: Sand
From where was the sample collected: Source
Laboratory sample identification: 14FPCC-0095 C872690
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Cemex

Material Information

Source Identification (SMARA or name of Pit): 91-39-0015
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: Cemex Kerlinger Stockpile
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 1 of 1

DIME Test ID: 2014-03-20-11077038-1
Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand
Verified Date: 03/21/2014
Date Tested: 03/20/2014
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bang.d.nguyen@dot.ca.gov
Organization Phone: (916) 227-7204
General Comments for this Test:
Additional Comments When Verified:
Is the sample satisfactory or not? Yes
Does debris exist No

Tests Assigned to this Sample

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