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Sample Record for 2014-06-04-13456437

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Project Information

Project ID: 7427 DEA: 07215934 EFIS: 0700001833 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-2.4/4.0
Work Description: Widen and Realign Freeway and Construct Ped OC, OC and UC Structures.
Location Description: LOS ANGELES COUNTY IN SANTA FE SPRINGS AND NORWALK FROM 0.1 MILE NORTH OF CARMENITA ROAD OVERCROSSING TO 0.1 MILE NORTH OF SILVERBOW AVENUE PEDESTRIAN OVERCROSSING
Contractor Name: FLATIRON WEST INC
Contractor Address: 1770 La Costa Meadows Drive, San Marcos, CA 92078
Resident Engineer: Mashhur Ali Structure Rep.: Kim, Steven

Sample Information

DIME Sample ID: 2014-06-04-13456437
TL Number from the TL Form:
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Annual Source Testing
Type of Material: Aggregate
Sample Taken Date: 06/04/2014
Date that the sample was received by the laboratory/organization performing the testing: 06/04/2014
The quantity of what the sample constitutes: 4 bags
A brief description of the sample: Washed Concrete Sand
From where was the sample collected: Source
Laboratory sample identification: 4198B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Materials Company Reliance

Material Information

Source Identification (SMARA or name of Pit): SMARA 91-19-0016
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: Stockpiles
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: fine
The concrete mix design number:
Lot number:
Sublot number:

Test Results

Test Information 2 of 5

DIME Test ID: 2014-06-04-13456437-2
Test Method: CTM 207-March 2012: Method of Test for Specific Gravity and Absorption of Fine Aggregate
Verified Date: 02/20/2015
Date Tested: 07/29/2014
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:
% Absorption 1.1 %
Specific Gravity 2.67

Tests Assigned to this Sample

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