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Testing Report for 2015-11-30-9-1

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

Project Information

DEA: 042640U4
EFIS: 0412000195
Project ID: 7463
QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-101-0.9/3.6
Work Description: CONSTRUCT PETALUMA BLVD SOUTH INTERCHANGE, REPLACE PETALUMA RIVER BR
Location Description: SONOMA COUNTY IN AND NEAR PETALUMA FROM GUNN DRIVE TO ROUTE 101/116 SEPARATION AND OVERHEAD
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Richard Duncan
Structure Rep.: Brian Beaudoin

Sample Information

DIME Sample ID: 2015-11-30-9
TL Number from the TL Form: c862735
Sample Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Sample Organization Contact: (916) 227-7204
Type of Sample: Annual Source Testing
Type of Material: Aggregate
Sample Taken Date: 11/30/2015
Date that the sample was received by the laboratory/organization performing the testing: 2/16/2016
The quantity of what the sample constitutes: 5 bags
A brief description of the sample: 1 x 4 PCC Aggregate
From where was the sample collected: Source
Laboratory sample identification: 16CPCC-0071
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Syar Lake Herman

Material Information

Source Identification (SMARA or name of Pit): 91-48-0002
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Stockpile
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size:
The concrete mix design number:
Lot number:
Sublot number:

Test Information

DIME Test ID: 2015-11-30-9-1
Test Method: CTM 214-August 2010: Method of Test for Soundness of Aggregates by Use of Sodium Sulfate
Date Tested: 3/21/2016
Verified Date: 3/24/2016
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:
Test Result Compliance: complies
Additional Comments When Verified :

Submitted Test Results

Percentage Loss of material retained on 2 x 1 ½ in. sieve: no data
Percentage Loss of material retained on 1 ½ x 1 in. sieve: no data
Percentage Loss of material retained on 1 x ¾ in. sieve: no data
Percentage Loss of material retained on ¾ x ½ in. sieve: no data
Percentage Loss of material retained on ½ x ⅜ in. sieve: no data
Percentage Loss of material retained on ⅜ in. x #4 sieve: no data
Weighted Average Percent Loss of Coarse Aggregate: 3.1 %