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Testing Report for 2019-02-12-5-5

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

Project Information

DEA: 072159U4
EFIS: 0715000160
Project ID: 211260
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work Description: CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description: LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: George Saker
Structure Rep.: Danny Lalonde

Sample Information

DIME Sample ID: 2019-02-12-5
TL Number from the TL Form: Unknown
Sample Submitted By Organization: G3 Quality, Inc. - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 2/12/2019
Date that the sample was received by the laboratory/organization performing the testing: 2/13/2019
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: Rock and Sand
From where was the sample collected: Source
Laboratory sample identification: Mix S72500
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: National Ready Mix Artesia

Material Information

Source Identification (SMARA or name of Pit): 91-19-0027: Corona
The fabricator's/manufacturer's product name for the sample: Set 1
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Unknown
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number: S72500
Lot number: Unknown
Sublot number: Unknown

Test Information

DIME Test ID: 2019-02-12-5-5
Test Method: CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)
Date Tested: 2/13/2019
Verified Date: 6/27/2019
Submitted By Organization: G3 Quality, Inc. - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: (562) 321-9840
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Cleanness value (11/2 in. maximum aggregate mix): 90