Test 2021-03-29-24-8 (CTM 213-December 2012) Summary

Project Information
Project IdentifiersProject ID: 214885
DEA: 080K1234
EFIS: 0815000242
DIST-CO-RTE-PM08-SBD-15-64.6/75.3
Work DescriptionCOLD PLANE ASPHALT CONCRETE PAVEMENT AND PLACE RHMA-G.
Location DescriptionSAN BERNARDINO COUNTY FROM 1.2 MILES SOUTH OF SIDEWINDER ROAD OVERCROSSING TO MOJAVE RIVER BRIDGE
Sample Information
Sample Taken Date3/29/2021 Sample Unique Key24
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 testing3/29/2021
Sample typeAnnual Source Testing A brief description of the sampleWashed Concrete Sand
The quantity of what the sample constitutes1 Bag From where was the sample collectedSource
First name of sampler or witnessed byChris Last name of sampler or witnessed byHindman
Title of samplerQC Technician Laboratory sample identification
The fabricator/manufacturer/facility nameRobertsons Lucern Quarry Transportation Laboratory (TL) Number3605
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)91-36-0116
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 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: 2021-03-29-24
DIME Test ID: 2021-03-29-24-8
Testing Lab: CT - Southern Regional Laboratory
Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand
Test Release Date: 2021-05-04
Test Results

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 05/04/2021