Test 2021-03-26-19-8 (CTM 213-December 2012) Summary

Project Information
Project IdentifiersProject ID: 215212
DEA: 081F1434
EFIS: 0815000233
DIST-CO-RTE-PM08-RIV-15-38.2/51.5
Work DescriptionINDIVIDUAL SLAB REPLACEMENT, REPLACE BASE & GRIND CONCRETE PAVEMENT.
Location DescriptionRIVERSIDE COUNTY IN CORONA AND EASTVALE FROM 0.5 MILE SOUTH OF ONTARIO AVENUE UNDERCROSSING TO ROUTE 60/15 SEPARATION
Sample Information
Sample Taken Date3/26/2021 Sample Unique Key19
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 testing3/27/2021
Sample typeAnnual Source Testing A brief description of the sampleWashed Concrete Sand
The quantity of what the sample constitutes5 bgas From where was the sample collectedSource
First name of sampler or witnessed byRMA Last name of sampler or witnessed byQuarry QC Tech
Title of samplerQC Technician Laboratory sample identification
The fabricator/manufacturer/facility namePacific Aggregate Alberhill Transportation Laboratory (TL) Number3525
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)unknown
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: 2021-03-26-19
DIME Test ID: 2021-03-26-19-8
Testing Lab: CT - Southern Regional Laboratory
Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand
Test Release Date: 2021-04-19
Test Results

Input Type: Calculated
Tester's full name: Stish Jain
Date of test: 04/08/2021
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 04/19/2021