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Sample Record for 2018-07-06-5

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

Project Information

Project ID: 210808 DEA: 020E0904 EFIS: 0200000016 QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-5-R29.3/R31.1,R45.0/R45.8
Work Description: REPLACE BRIDGE, REALIGN ROADWAY AND SEISMIC RETROFIT
Location Description: IN SHASTA COUNTY ABT 8 MI N OF SHASTA LAKE CTY AND NEAR LAKEHEAD FRM TURNTABLE BAY O/C TO 0.1 MI N OF O'BRIEN SRRA & FRM 0.4 MI S TO 0.3 MI N OF DOG CREEK BRIDGE.
Contractor Name: GOLDEN STATE BRIDGE, INC.
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Nathan Alexander Structure Rep.: Christopher S 'Chris' Brace

Sample Information

DIME Sample ID: 2018-07-06-5
TL Number from the TL Form: c340592
Sample Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Sample Organization Contact: (916) 227-7204
Type of Sample: Per Request
Type of Material: Aggregate
Sample Taken Date: 07/06/2018
Date that the sample was received by the laboratory/organization performing the testing: 07/13/2018
The quantity of what the sample constitutes: 1 5gal bucket
A brief description of the sample: RC sand
From where was the sample collected: Source
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: redding concrete

Material Information

Source Identification (SMARA, name of Pit or Job Site): not provided
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: redding concrete
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:
Aggregate Mix Number:
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2018-07-06-5-1
Test Method: ASTM C128-12: Standard Test Method for Relative Density (Specific Gravity) and Absorption of Fine Aggregate
Verified Date: 07/19/2018
Date Tested: 07/19/2018
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
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:
Basis for testing Oven Dry
Specific Gravity 2.56
Density no data
Absorption 2.1 %

Test 2 of 3

DIME Test ID: 2018-07-06-5-2
Test Method: ASTM C128-12: Standard Test Method for Relative Density (Specific Gravity) and Absorption of Fine Aggregate
Verified Date: 07/19/2018
Date Tested: 07/19/2018
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
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:
Basis for testing Apparent
Specific Gravity 2.71
Density no data
Absorption 2.1 %

Test 3 of 3

DIME Test ID: 2018-07-06-5-3
Test Method: ASTM C128-12: Standard Test Method for Relative Density (Specific Gravity) and Absorption of Fine Aggregate
Verified Date: 07/19/2018
Date Tested: 07/19/2018
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
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:
Basis for testing Saturated Surface Dry
Specific Gravity 2.62
Density no data
Absorption 2.1 %