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Testing Report for 2016-06-17-18-3

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

Project Information

DEA: 07288604
EFIS: 0700021080
Project ID: 208945
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-710-6.0-9.4
Work Description: Gerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing.
Location Description: Port of Long Beach (District 7)
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer:
Structure Rep.:

Sample Information

DIME Sample ID: 2016-06-17-18
TL Number from the TL Form: C-16-106
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: 6/17/2016
Date that the sample was received by the laboratory/organization performing the testing: 5/17/2016
The quantity of what the sample constitutes: 6 Bags
A brief description of the sample: Washed Concrete Sand
From where was the sample collected: Source
Laboratory sample identification: 6178B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Reliance

Material Information

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

Test Information

DIME Test ID: 2016-06-17-18-3
Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand
Date Tested: 6/8/2016
Verified Date: 10/15/2019
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: complies
Additional Comments When Verified :

Submitted Test Results

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