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Testing Report for 2013-11-26-7307996-2

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

Project Information

Project ID: 3958 DEA: 07215914 EFIS: 0700001831 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-1.2/2.1
Work Description: WIDEN AND REALIGN FREEWAY AND RECONSTRUCT OVERCROSSING STRUCTURE.
Location Description: LOS ANGELES COUNTY IN SANTA FE SPRINGS FROM 0.3 MILE SOUTH OF NORTH FORK COYOTE CREEK BRIDGE TO 0.3 MILE NORTH OF MARQUARDT AVENUE AND AT NORWALK HUB AND LOS ANGELES REGIONAL TRANSPORTATION MANAGEMENT CENTER
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Kelvin Tran Structure Rep.: Dan LaLonde

Sample Information

DIME Sample ID: 2013-11-26-7307996
TL Number from the TL Form: Unknown
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: 11/26/2013
Date that the sample was received by the laboratory/organization performing the testing: 11/27/2013
The quantity of what the sample constitutes: 2 Half Bags
A brief description of the sample: Structure Backfill
From where was the sample collected: Source
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Unknown

Material Information

Source Identification (SMARA or name of Pit): NA
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: RW 13
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: 2013-11-26-7307996-1
Test Method: CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates
Verified Date: 02/20/2015
Date Tested: 11/26/2013
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: comply
Additional Comments When Verified :

Submitted Test Results

Number of tests 1
Sand equivalent after temperature correction 23