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Testing Report for 2017-03-24-5-1

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

Project Information

DEA: 022H7404
EFIS:
Project ID: 211560
QA Service Level: 1
DIST-CO-RTE-PM: 02-TRI-299-23.3
Work Description: Slide repair, catchment basin
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: TOFAEL ANWAR
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2017-03-24-5
TL Number from the TL Form: c897935
Sample Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Sample Organization Contact: (916) 227-7204
Type of Sample: Quality Control
Type of Material: Soil
Sample Taken Date: 3/24/2017
Date that the sample was received by the laboratory/organization performing the testing: 4/10/2017
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: Native Soil
From where was the sample collected: Job Site
Laboratory sample identification: 17soil-0076
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Corral Botton Transfer Station

Material Information

The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: surface soil
Where the material sample would have been placed if not sampled: 0 to 1 ft

Test Information

DIME Test ID: 2017-03-24-5-1
Test Method: CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates
Date Tested: 4/12/2017
Verified Date: 4/12/2017
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:
Additional Comments When Verified :

Submitted Test Results

No reportable test results have been submitted for this test.