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Testing Report for 2014-09-10-9-3

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

Project Information

DEA: 100S1104
EFIS: 1000000229
Project ID: 208679
QA Service Level: 1
DIST-CO-RTE-PM: 10-SJ-4,5-Var
Work Description: SR-4 FREEWAY EXTENSION
Location Description: IN SAN JOAQUIN COUNTY
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Harminder Deol
Structure Rep.: Alex Lara

Sample Information

DIME Sample ID: 2014-09-10-9
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Sample Organization Contact: (916) 227-7204
Type of Sample: Annual Source Testing
Type of Material: Aggregate
Sample Taken Date: 9/10/2014
Date that the sample was received by the laboratory/organization performing the testing: 9/10/2014
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: Sand
From where was the sample collected: Source
Laboratory sample identification: 14FPCC-302 C638417C
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Confab KRC

Material Information

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

Test Information

DIME Test ID: 2014-09-10-9-3
Test Method: CTM 217-June 2011: Method of Test for Sand Equivalent
Date Tested: 9/15/2014
Verified Date: 9/17/2014
Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bang.d.nguyen@dot.ca.gov
Organization Phone: (916) 227-7204
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Number of tests: 1
Sand equivalent after temperature correction: 79