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Testing Report for 2019-08-02-23-5

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

Project Information

DEA: 080K2934
EFIS: 0812000100
Project ID: 213551
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-10-R36.8/R39.2
Work Description: PAVEMENT REHABILITATION AND CONTINUOUSLY REINFORCED CONCRETE PAVEMENT
Location Description: SAN BERNARDINO COUNTY IN YUCAIPA FROM 0.2 MILE WEST OF LIVE OAK CANYON ROAD TO COUNTY LINE ROAD UNDERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Ezz Gayed
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-08-02-23
TL Number from the TL Form: C 003101-6
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Per Request
Type of Material: Aggregate
Sample Taken Date: 8/2/2019
Date that the sample was received by the laboratory/organization performing the testing: 8/2/2019
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: Class 2 Agg Subbase
From where was the sample collected: Job Site
Laboratory sample identification: 8664
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Caltrans

Material Information

Source Identification (SMARA or name of Pit): Unknown
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: I-10 Lanes number 1 and 2
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1-1/2 inch
The concrete mix design number: Unknown
Lot number: Unknown
Sublot number: Unknown

Test Information

DIME Test ID: 2019-08-02-23-5
Test Method: CTM 217-June 2011: Method of Test for Sand Equivalent
Date Tested: 8/12/2019
Verified Date: 9/16/2019
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: 21