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Testing Report for 2014-05-12-6167799-1

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

Project Information

Project ID: 7446 DEA: 06442624 EFIS: 0600000972 QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE,MAD-99-26.7/R31.6,R0.0/R1.6
Work Description: FREEWAY TO BE WIDENED AND REPLACE BRIDGE.
Location Description: FRESNO AND MADERA COUNTIES IN AND NEAR FRESNO FROM 0.2 MILES NORTH OF ASHLAN AVENUE OVERCROSSING TO 0.6 MILE NORTH OF AVENUE 7 OVERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Alan Vong Structure Rep.: Mano Mirzai

Sample Information

DIME Sample ID: 2014-05-12-6167799
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: 05/12/2014
Date that the sample was received by the laboratory/organization performing the testing: 04/29/2014
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-0229 C812745D
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Friant

Material Information

Source Identification (SMARA or name of Pit): NA
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: 2014-05-12-6167799-1
Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand
Verified Date: 05/19/2014
Date Tested: 05/12/2014
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