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Testing Report for 2019-03-11-17-11

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

Project Information

DEA: 080N9724
EFIS: 0815000102
Project ID: 213647
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-395-35.5/39.1
Work Description: CONSTRUCT MEDIAN AND WIDENING SHOULDER
Location Description: SAN BERNARDINO COUNTY NEAR ADELANTO FROM 1.3 MILES SOUTH TO 2.3 MILES NORTH OF KRAMER ROAD
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: IHAB BOULOS
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-03-11-17
TL Number from the TL Form:
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Annual Source Testing
Type of Material: Aggregate
Sample Taken Date: 3/11/2019
Date that the sample was received by the laboratory/organization performing the testing: 3/11/2019
The quantity of what the sample constitutes: 2 bags
A brief description of the sample: Washed Concrete Sand
From where was the sample collected: Source
Laboratory sample identification: 8519
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Agcon- Oro Grande

Material Information

Source Identification (SMARA or name of Pit): 91-36-0046::AGCON, INC.
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: Stockpile @ Plant
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: Unknown
Sublot number: Unknown

Test Information

DIME Test ID: 2019-03-11-17-11
Test Method: CTM 217-June 2011: Method of Test for Sand Equivalent
Date Tested: 3/18/2019
Verified Date: 5/1/2019
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: complies
Additional Comments When Verified :

Submitted Test Results

Number of tests: 2
Sand equivalent after temperature correction: 82