DIME - Test Summary

Summary for Test 2021-03-29-24-8

Test performed: CTM 213-December 2012

Sample Taken Date	03/29/2021	Sample Unique Key	24
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 testing	03/29/2021
Sample type	Annual Source Testing	A brief description of the sample	Washed Concrete Sand
The quantity of what the sample constitutes	1 Bag	From where was the sample collected	Source
First name of sampler or witnessed by	Chris	Last name of sampler or witnessed by	Hindman
Title of sampler	QC Technician	Telephone number of sampler
Laboratory sample identification		Linked DIME Sample ID
The fabricator/manufacturer/facility name	Robertsons Lucern Quarry	Transportation Laboratory (TL) Number	3605
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	91-36-0116
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	Stockpile @ Plant
Where the material sample would have been placed if not sampled		Primary Aggregate Nominal Size	fine
The concrete mix design number		Lot number
Sublot number		Aggregate Mix Number	Not set

DIME Sample ID: 2021-03-29-24

DIME Test ID: 2021-03-29-24-8

Testing Lab: CT D08 - Fontana Southern Regional Laboratory

Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand

Test Release Date: 2021-05-04

Input Type: Calculated

Tester's full name: Satish Jain

Date of test: 04/21/2021

Is the sample satisfactory or not?: Yes

Does debris exist: No

General comments (publicly viewable) (Max 1000 characters):

Test was verified on 5/4/2021 ✔