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Testing Report for 2015-12-23-13-1

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

Project Information

DEA: 062HT104
EFIS: 0612000287
Project ID: 210794
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-99-23.5/26.7
Work Description: (Alternative Delivery) Realign Freeway CONTACT SMR PRIOR TO PERFORMING ANY TESTING OR INSPECTION. CMGC PROJECT. Realign Route 99 between Ashlan Avenue and Olive Avenue to accommodate the High Speed Train (HST).
Location Description: State Highway 99 in Fresno (Fresno County) from 0.2 miles North of Olive Ave over-crossing to 0.2 miles North of Ashlan Ave over-crossing.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Justin Kimura
Structure Rep.: Daniel Chapa

Sample Information

DIME Sample ID: 2015-12-23-13
TL Number from the TL Form: c812327
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: 12/23/2015
Date that the sample was received by the laboratory/organization performing the testing: 4/5/2016
The quantity of what the sample constitutes: 8 Bags
A brief description of the sample: Fine PCC Aggregate
From where was the sample collected: Source
Laboratory sample identification: 16FPCC-0170
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan - Triangle Rock Los Banos

Material Information

Source Identification (SMARA or name of Pit): 91-24-0009
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: 2015-12-23-13-1
Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand
Date Tested: 4/14/2016
Verified Date: 4/14/2016
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

Is the sample satisfactory or not?: Yes
Does debris exist: No