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Testing Report for 2016-07-06-10-2

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

Project Information

DEA: 083401U4
EFIS: 0800000609
Project ID: 208682
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-138,138-6.2/6.4,2.3/R15.2
Work Description: WIDEN TO 4 LNS FR BEEKLEY RD TO JCT 15, ADD 1 LN EB FR PHELAN RD TO
Location Description: SAN BERNARDINO COUNTY ON ROUTE 138 NEAR PHELAN FROM 0.6 MILE WEST OF PHELAN ROAD TO THE JUNCTION OF ROUTE 15 AND ON ROUTE 2 FROM 0.1 MILE NORTH OF WILD HORSE CANYON ROAD TO ROUTE 138
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Elvira Lenart
Structure Rep.: Osama Abdalla

Sample Information

DIME Sample ID: 2016-07-06-10
TL Number from the TL Form: C 947965
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 7/6/2016
Date that the sample was received by the laboratory/organization performing the testing: 7/13/2016
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: Class 2 Aggregate Base
From where was the sample collected: Job Site
Laboratory sample identification: 6282B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: NA

Material Information

Source Identification (SMARA or name of Pit): Unknown
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: A Line Sta 484 00 Lt Mainline Sample 2
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number:
Lot number:
Sublot number:

Test Information

DIME Test ID: 2016-07-06-10-2
Test Method: CTM 217-June 2011: Method of Test for Sand Equivalent
Date Tested: 7/15/2016
Verified Date: 8/22/2019
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:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Number of tests: 1
Sand equivalent after temperature correction: 65