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Testing Report for 2014-08-05-5-2

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

Project Information

Project ID: 208798 DEA: 080R1904 EFIS: 0812000031 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-74-23.1
Work Description: INSTALL LIGHTING AND TRAFFIC SIGNALS.
Location Description: RIVERSIDE COUNTY NEAR PERRIS AT THEDA STREET
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Moises Ramos Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2014-08-05-5
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: 08/05/2014
Date that the sample was received by the laboratory/organization performing the testing: 08/05/2014
The quantity of what the sample constitutes: 3 Bags
A brief description of the sample: Washed Concrete Sand
From where was the sample collected: Source
Laboratory sample identification: 4211B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Robertsons Banning Quarry

Material Information

Source Identification (SMARA or name of Pit): SMARA 91-33-0012
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: Stockpiles
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: fine
The concrete mix design number:
Lot number:
Sublot number:

Test Information

DIME Test ID: 2014-08-05-5-1
Test Method: CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates
Verified Date: 02/20/2015
Date Tested: 02/20/2015
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: comply
Additional Comments When Verified :

Submitted Test Results

% Absorption 1 %
Specific Gravity 2.72