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Testing Report for 2015-01-16-8-5

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

Project Information

DEA: 071218W4
EFIS: 0700021119
Project ID: 7613
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-29.4/31.6
Work Description: REALIGN ROUTE 5 AND RAILROAD TRACKS AND RECONFIGURE ON- AND OFF-RAMPS.
Location Description: LOS ANGELES COUNTY IN BURBANK FROM WEST MAGNOLIA BOULEVARD OVERCROSSING TO 0.3 MILE NORTH OF BUENA VISTA STREET/WINONA AVENUE UNDERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Vladimir Gurfinkel
Structure Rep.: Gon Choi

Sample Information

DIME Sample ID: 2015-01-16-8
TL Number from the TL Form: C15 32
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: 1/16/2015
Date that the sample was received by the laboratory/organization performing the testing: 1/16/2015
The quantity of what the sample constitutes: 6 Bags
A brief description of the sample: Three eighths inch PCC Aggregates
From where was the sample collected: Source
Laboratory sample identification: 5111B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Sun Valley Boulevard

Material Information

Source Identification (SMARA or name of Pit): SMARA 91-19-0019
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: 3/8 inch
The concrete mix design number:
Lot number:
Sublot number:

Test Information

DIME Test ID: 2015-01-16-8-5
Test Method: CTM 227-June 2012: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)
Date Tested: 1/27/2015
Verified Date: 2/23/2015
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