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Testing Report for 2016-06-04-3-3

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

Project Information

DEA: 07215954
EFIS: 0700001835
Project ID: 209141
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-0.0/7.6
Work Description: WIDENING FREEWAY AND RECONSTRUCT OVERHEAD AND OVERCROSSING STRUCTURES
Location Description: LOS ANGELES COUNTY IN LA MIRADA, SANTA FE SPRINGS, NORWALK AND DOWNEY FROM ORANGE COUNTY/LOS ANGELES COUNTY LIMIT LINES TO 0.7 MILE NORTH OF ROUTE 605
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Thang Ton
Structure Rep.: Amare Tsagie

Sample Information

DIME Sample ID: 2016-06-04-3
TL Number from the TL Form: Unknown
Sample Submitted By Organization: G3 Quality, Inc. - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 6/4/2016
Date that the sample was received by the laboratory/organization performing the testing: 6/4/2016
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: rock and sand
From where was the sample collected: Source
Laboratory sample identification: Mix 1536953
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: National Ready Mix

Material Information

Source Identification (SMARA or name of Pit): 91-19-0007
The fabricator's/manufacturer's product name for the sample: set 1
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Batch Plant
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number: 1536953
Lot number:
Sublot number:

Test Information

DIME Test ID: 2016-06-04-3-3
Test Method: CTM 217-November 2014: Method of Test for Sand Equivalent
Date Tested: 6/4/2016
Verified Date: 1/13/2017
Submitted By Organization: G3 Quality, Inc. - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: (562) 321-9840
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Sand Equivalent: 81