Test 2020-12-12-9-1 (CTM 213-December 2012) Summary

Project Information
Project IdentifiersProject ID: 212618
DEA: 044G0564
EFIS: 0417000154
DIST-CO-RTE-PM04-ALA-680-M2.4/M12.4
Work DescriptionROADWAY REHAB, BRIDGE REPLACEMENT, RET. WALLS, TOLL SYSTEMS
Location DescriptionFREMONT AND AT SUNOL FROM MISSION BOULEVARD SEPARATION TO KOOPMAN ROAD UNDERCROSSING
Sample Information
Sample Taken Date12/12/2020 Sample Unique Key9
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing1/4/2021
Sample typeQuality Assurance A brief description of the sampleSand
The quantity of what the sample constitutes1 bag From where was the sample collectedSource
First name of sampler or witnessed byD. Last name of sampler or witnessed byYeung
Title of sampler Laboratory sample identification21-FPCC-0003
The fabricator/manufacturer/facility nameDeSilva Gates Sunol Transportation Laboratory (TL) NumberC968746
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name
Material Information
Material TypeAggregate Source Identification (SMARA or name of Pit)91-01-0007
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 collectedStockpile @ Plant
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Sizefine
The concrete mix design number Lot number
Sublot number HMA Design ID
Test Details
DIME Sample ID: 2020-12-12-9
DIME Test ID: 2020-12-12-9-1
Testing Lab: CT HQ - Sacramento Aggregate Testing Laboratory
Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand
Test Release Date: 2021-01-25
Test Results

Input Type: Measured
Tester's full name: Bang Nguyen
Date of test: 01/22/2021
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 01/25/2021