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Testing Report for 2019-01-28-1-9

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

Project Information

DEA: APP
EFIS: 0019000052
Project ID: 66666
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for Aggregate Pre-approval Program (APP). Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-01-28-1
TL Number from the TL Form:
Sample Submitted By Organization: CT SC Sub-unit 3668-105
Sample Organization Contact:
Type of Sample: Aggregate Prequalification Program
Type of Material: Aggregate
Sample Taken Date: 1/28/2019
Date that the sample was received by the laboratory/organization performing the testing: 1/28/2019
The quantity of what the sample constitutes: Test APP
A brief description of the sample: Test APP
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Test APP

Material Information

Source Identification (SMARA or name of Pit): Test APP
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: Test APP
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 3/8 inch
The concrete mix design number: Unknown
Lot number:
Sublot number:

Test Information

DIME Test ID: 2019-01-28-1-9
Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand
Date Tested: 3/21/2019
Verified Date: 3/23/2019
Submitted By Organization: CT SC Sub-unit 3668-105
Organization Address: ,
Organization City:
Organization State:
Organization Zipcode:
Organization Email:
Organization Phone:
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: Yes