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Testing Report for 2019-12-13-17-2

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

Project Information

DEA: 073W8804
EFIS: 0717000127
Project ID: 213976
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-1-56.9/62.9
Work Description: APPLY SLURRY SEAL AND REPLACE AC SURFACING.
Location Description: LOS ANGELES COUNTY IN LOS ANGELES FROM TRANCAS CANYON ROAD/BROAD BEACH ROAD TO THE VENTURA COUNTY LINE
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Gilbert Trujillo
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-12-13-17
TL Number from the TL Form: C914681
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: 12/13/2019
Date that the sample was received by the laboratory/organization performing the testing: 12/18/2019
The quantity of what the sample constitutes: 1 Bags
A brief description of the sample: Aggregate Type III for Slurry Seal
From where was the sample collected: Job Site
Laboratory sample identification: 9036
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Unknown

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: STOCKPILE @ JOBSITE
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: fine
The concrete mix design number: Unknown
Lot number: Unknown
Sublot number: Unknown

Test Information

DIME Test ID: 2019-12-13-17-2
Test Method: CTM 217-June 2011: Method of Test for Sand Equivalent
Date Tested: 12/30/2019
Verified Date: 3/13/2020
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:
Additional Comments When Verified :

Submitted Test Results

Number of tests: 3
Sand equivalent after temperature correction: 56