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Testing Report for 2014-03-25-11316738-1

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

Project Information

Project ID: 6959 DEA: 04297614 EFIS: 0400020580 QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-84-25.5/27.1
Work Description: WIDEN EXIST HWY AND BR; CONSTRUCT AN ACCESS BR AND RETAINING WALLS.
Location Description: ALAMEDA COUNTY IN AND NEAR LIVERMORE FROM 0.4 MILE NORTH OF CONCANNON BOULEVARD TO JACK LONDON BOULEVARD
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Rommel Pardo Structure Rep.: Oanh Bui

Sample Information

DIME Sample ID: 2014-03-25-11316738
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Sample Organization Contact: (916) 227-7204
Type of Sample: Annual Source Testing
Type of Material: Aggregate
Sample Taken Date: 03/25/2014
Date that the sample was received by the laboratory/organization performing the testing: 03/17/2014
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: Sand
From where was the sample collected: Source
Laboratory sample identification: 14FPCC-0124 C738980
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sante Fe Aggregate Waterford Plant

Material Information

Source Identification (SMARA or name of Pit): 91-50-0006
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Stockpile
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size:
The concrete mix design number:
Lot number:
Sublot number:

Test Information

DIME Test ID: 2014-03-25-11316738-1
Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand
Verified Date: 03/25/2014
Date Tested: 03/25/2014
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

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