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Testing Report for 2020-10-15-2-3

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

Project Information

Project ID: 66667 DEA: JMFPP EFIS: 0019000043 QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for JMF Prequalification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2020-10-15-2
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - DME / District Lab
Sample Organization Contact: (510) 507-3456
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 10/15/2020
Date that the sample was received by the laboratory/organization performing the testing: 10/15/2020
The quantity of what the sample constitutes: 8 Bags
A brief description of the sample: 8 Bags of Aggregate
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Syar Industries

Material Information

Source Identification (SMARA or name of Pit): 91-49-0004
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Canyon Rock
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number:
Sublot number:

Test Information

DIME Test ID: 2020-10-15-2-1
Test Method: AASHTO T84-14: Standard Method of Test for Specific Gravity and Absorption of Fine Aggregate (Fine Specific Gravity)
Verified Date: 10/16/2020
Date Tested: 09/21/2020
Submitted By Organization: CT D04 - DME / District Lab
Organization Address: 21339 Cabot Blvd,
Organization City: Hayward
Organization State: CA
Organization Zipcode: 94545
Organization Email: mohammad.dehghan@dot.ca.gov
Organization Phone: (510) 507-3456
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Number of tests 2
Mass Determination Air
Specific Gravity for Sample 1 2.465
Specific Gravity for Sample 2 2.466
Average Specific Gravity 2.456