Test 2021-02-08-31-1 (CTM 213-December 2012) Summary

Project Information
Project IdentifiersProject ID: 214422
DEA: 040J6424
EFIS: 0414000476
DIST-CO-RTE-PM04-SON-101-32.8/R54.2
Work DescriptionCRACK, SEAT AND OVERLAY WITH RHMA AND HMA, AND REPLACE CULVERTS.
Location DescriptionSONOMA COUNTY AT VARIOUS LOCATIONS FROM LIMERICK LANE OVERCROSSING TO ROUTE 101/128 SEPARATION
Sample Information
Sample Taken Date2/8/2021 Sample Unique Key31
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 testing4/13/2021
Sample typeAnnual Source Testing A brief description of the sampleFine aggregate
The quantity of what the sample constitutes1 bag From where was the sample collectedSource
First name of sampler or witnessed byCJ Last name of sampler or witnessed bySousa
Title of samplerPlant QC Laboratory sample identification21-PCCF-0065
The fabricator/manufacturer/facility nameHealdsburg Transportation Laboratory (TL) NumberC044326
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)91-49-0030
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 collectedstock pile
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: 2021-02-08-31
DIME Test ID: 2021-02-08-31-1
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: 2021-05-04
Test Results

Input Type: Measured
Tester's full name: Ryan Kester
Date of test: 04/29/2021
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