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Testing Report for 2021-04-01-31-2

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

Project Information

DEA: 022E4804
EFIS: 0200000586
Project ID: 212501
QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-96,263-103.1/103.6,56.8/57.2
Work Description: BRIDGE REPLACEMENT
Location Description: SISKIYOU COUNTY ABOUT 8 MILES NORTH OF YREKA ON ROUTE 96 FROM 0.5 MILE WEST TO 0.2 MILE EAST OF ROUTE 263 AND ON ROUTE 263 FROM 0.3 MILE NORTH OF SHASTA RIVER BRIDGE #02-0014 TO ROUTE 96
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Nicole Mallory
Structure Rep.: Andy O'Sullevan

Sample Information

DIME Sample ID: 2021-04-01-31
TL Number from the TL Form: 897282
Sample Submitted By Organization: CT D02 - North Region Materials Lab
Sample Organization Contact: (530) 225-3194
Type of Sample: Authorization
Type of Material: Aggregate
Sample Taken Date: 4/1/2021
Date that the sample was received by the laboratory/organization performing the testing: 4/5/2021
The quantity of what the sample constitutes: Process
A brief description of the sample: 3/4-inch Maximum Class 2 Aggregate Base
From where was the sample collected: Source
Laboratory sample identification: D78756
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Roadway

Material Information

Source Identification (SMARA or name of Pit): Undeclared
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: Grindings from Hwy 96
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number:
Sublot number:

Test Information

DIME Test ID: 2021-04-01-31-2
Test Method: CTM 217-June 2011: Method of Test for Sand Equivalent
Date Tested: 4/6/2021
Verified Date: 5/14/2021
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Dr,MS-83
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
General Comments for this Test: The SE is 44.
Test Result Compliance: complies
Additional Comments When Verified :

Submitted Test Results

Number of tests: 1
Sand equivalent after temperature correction: 43