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Testing Report for 2019-10-14-28-4

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

Project Information

DEA: APP
EFIS: 0019000052
Project ID: 66666
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for Aggregate Pre-approval Program (APP). Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-10-14-28
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: Aggregate Prequalification Program
Type of Material: Aggregate
Sample Taken Date: 10/14/2019
Date that the sample was received by the laboratory/organization performing the testing: 10/24/2019
The quantity of what the sample constitutes: production stockpile.
A brief description of the sample: 3/8 Pea Gravel
From where was the sample collected: Manufacturer
Laboratory sample identification: 19-APPC-0164
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Materials Woodland

Material Information

Source Identification (SMARA or name of Pit): 91-57-0002::WOODLAND PLANT
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 @ 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: 2019-10-14-28-4
Test Method: CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)
Date Tested: 11/8/2019
Verified Date: 11/22/2019
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

Cleanness value (11/2 in. maximum aggregate mix): 84