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Testing Report for 2014-11-05-9-5

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

Project Information

DEA: 07245403
EFIS: 0700000431
Project ID: 7409
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-10-31.1/32.3
Work Description: Construct Connector between I-10 and I-605 (Design Build Project) LA-10-31.1/32.3, LA-605-R20.2/20.6
Location Description: 10 & 605 IC
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Hassan Azima
Structure Rep.: Ali EL-Zaynab

Sample Information

DIME Sample ID: 2014-11-05-9
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: 11/5/2014
Date that the sample was received by the laboratory/organization performing the testing: 11/7/2014
The quantity of what the sample constitutes: 3 Buckets
A brief description of the sample: One and a half inch rock
From where was the sample collected: Other
Laboratory sample identification: 4295B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: National Ready Mix Concrete Company

Material Information

Source Identification (SMARA or name of Pit): SMARA 91 19 0015
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: 1-1/2 inch
The concrete mix design number:
Lot number:
Sublot number:

Test Information

DIME Test ID: 2014-11-05-9-5
Test Method: CTM 227-June 2012: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)
Date Tested: 11/14/2014
Verified Date: 2/20/2015
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

Cleanness value (11/2 in. maximum aggregate mix): 94