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Testing Report for 2019-11-19-12-7

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

Project Information

Project ID: 66667 DEA: JMFPP EFIS: 0019000043 QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for JMF Prequalification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-11-19-12
TL Number from the TL Form: C911407
Sample Submitted By Organization: CT D01 - Field Laboratory
Sample Organization Contact: (707) 445-6373
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 11/19/2019
Date that the sample was received by the laboratory/organization performing the testing: 11/22/2019
The quantity of what the sample constitutes: JMF Prequalification
A brief description of the sample: 3/4" Coldfeed
From where was the sample collected: Manufacturer
Laboratory sample identification: 19-277
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: SYAR Lake Herman Drum

Material Information

Source Identification (SMARA or name of Pit): 91-48-0002::LAKE HERMAN 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: Cold Feed
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: Unknown
Lot number: Unknown
Sublot number: Unknown

Test Information

DIME Test ID: 2019-11-19-12-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Verified Date: 12/11/2019
Date Tested: 12/11/2019
Submitted By Organization: CT D01 - Field Laboratory
Organization Address: 1726 Albee St,
Organization City: Eureka
Organization State: CA
Organization Zipcode: 95501
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 445-6373
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Basis for relative density testing Bulk
Specific Gravity 2.608
Absorption 2.6 %