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Testing Report for 2020-06-25-48-4

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

Project Information

Project ID: 213469 DEA: 024C40V4 EFIS: 0218000125 QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-5-R3.8/R11.7
Work Description: WIDEN TO 6 LANES, BRIDGE REPLACEMENT AND WIDENING AND ROADWAY REHAB
Location Description: SHASTA COUNTY IN AND NEAR ANDERSON FROM ROUTE 5/273 SEPARATION TO 0.4 MILE SOUTH OF CHURN CREEK ROAD OVERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Henry Benner Structure Rep.: Eric Chaffee

Sample Information

DIME Sample ID: 2020-06-25-48
TL Number from the TL Form: 717974
Sample Submitted By Organization: CT D02 - North Region Materials Lab
Sample Organization Contact: (530) 225-3194
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 06/25/2020
Date that the sample was received by the laboratory/organization performing the testing: 06/25/2020
The quantity of what the sample constitutes: not provided
A brief description of the sample: 3/4" Shoulder Backing
From where was the sample collected: Job Site
Laboratory sample identification: D78495
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JF Shea Fawndale

Material Information

Source Identification (SMARA or name of Pit): 91-45-0017
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: Fawndale Plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number:

Test Information

DIME Test ID: 2020-06-25-48-1
Test Method: CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates
Verified Date: 10/22/2020
Date Tested: 06/25/2020
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Dr,MS-83
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Percent Coarse Crushed 97 %
Percent Fine Crushed 0 %