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Testing Report for 2019-12-19-25-2

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

Project Information

Project ID: 213741 DEA: 07325704 EFIS: 0716000089 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-1.7
Location Description: Santa Fe Springs, At 14044 Freeway Drive.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Mashhur Ali Structure Rep.: Nelson Parada

Sample Information

DIME Sample ID: 2019-12-19-25
TL Number from the TL Form: C07-ZA03
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 12/19/2019
Date that the sample was received by the laboratory/organization performing the testing: 12/23/2019
The quantity of what the sample constitutes: 1 BAG
A brief description of the sample: 1.0" PCC AGG
From where was the sample collected: Distributor
Laboratory sample identification: 9043
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: ROBERTSON 10

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: Belt Cut at SECURITY PAVING LA MIRADA
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number: Unknown
Lot number: Unknown
Sublot number: Unknown

Test Information

DIME Test ID: 2019-12-19-25-1
Test Method: CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates
Verified Date: 03/13/2020
Date Tested: 12/26/2019
Submitted By Organization: CT - Southern Regional Laboratory
Organization Address: 13970 Victoria St,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email:
Organization Phone: 213-792-4794
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Cleanness value (11/2 in. maximum aggregate mix) 29