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Testing Report for 2014-10-31-2-3

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

Project Information

DEA: 080F6604
EFIS: 0800000146
Project ID: 209263
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-247-1.8/9.6
Work Description: CONSTRUCT SHOULDERS, COLD PLANE AND HMA OVERLAY
Location Description: SAN BERNARDINO COUNTY IN AND NEAR YUCCA VALLEY FROM EL CORTEZ ROAD TO HANDLEY ROAD
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Samer Georges
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2014-10-31-2
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Annual Source Testing
Type of Material: Aggregate
Sample Taken Date: 10/31/2014
Date that the sample was received by the laboratory/organization performing the testing: 10/31/2014
The quantity of what the sample constitutes: 3 Bags
A brief description of the sample: Washed Concrete Sand
From where was the sample collected: Source
Laboratory sample identification: 4291B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Hi Grade Materials 29 Palms

Material Information

Source Identification (SMARA or name of Pit): SMARA 91-36-0055
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: Stockpiles
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: 2014-10-31-2-3
Test Method: CTM 217-June 2011: Method of Test for Sand Equivalent
Date Tested: 11/5/2014
Verified Date: 11/19/2014
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: comply
Additional Comments When Verified :

Submitted Test Results

Number of tests: 1
Sand equivalent after temperature correction: 82