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Testing Report for 2019-07-26-15-10

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

Project Information

DEA: 07304604
EFIS: 0714000073
Project ID: 212603
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-105-R0.5/R18.0
Work Description: UPGRADE EXISTING TRANSPORTATION MANAGEMENT SYSTEM ELEMENTS.
Location Description: LOS ANGELES COUNTY FROM ROUTE 1/105 SEPARATION IN EL SEGUNDO TO HOXIE AVENUE UNDERCROSSING IN NORWALK
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Bernard Alonzo
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-07-26-15
TL Number from the TL Form: C-19-000013
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: 7/26/2019
Date that the sample was received by the laboratory/organization performing the testing: 8/7/2019
The quantity of what the sample constitutes: 7 Bags
A brief description of the sample: 3/8" PCC Aggregate
From where was the sample collected: Source
Laboratory sample identification: 8671
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Robertsons - Cabazon

Material Information

Source Identification (SMARA or name of Pit): 91-33-0008::CABAZON QUARRY
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 at plant
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: Unknown
Sublot number: Unknown

Test Information

DIME Test ID: 2019-07-26-15-10
Test Method: CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)
Date Tested: 8/22/2019
Verified Date: 9/5/2019
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

Cleanness value (11/2 in. maximum aggregate mix): 94