Test 2021-01-18-15-1 (CTM 202-November 2011) Summary

Project Information
Project IdentifiersProject ID: 66666
DEA: APP
EFIS: 0019000052
DIST-CO-RTE-PM59---
Work DescriptionSpecial project for submitting Sample information for Aggregate Pre-approval Program (APP). Object Code: 1025. J2 DEA: 912680.
Location DescriptionNot set
Sample Information
Sample Taken Date1/18/2021 Sample Unique Key15
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 testing4/15/2021
Sample typeAggregate Prequalification Program A brief description of the sample1x4 Gravel
The quantity of what the sample constitutes6 buckets From where was the sample collectedSupplier
First name of sampler or witnessed byRene Last name of sampler or witnessed byMorquecho
Title of samplerQC Technician Laboratory sample identification
The fabricator/manufacturer/facility nameCemex Rockfield Transportation Laboratory (TL) Number
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)91-10-0014
The fabricator's/manufacturer's product name for the sample1x4 Gravel The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedStockpile
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design number Lot number
Sublot number HMA Design ID
Test Details
DIME Sample ID: 2021-01-18-15
DIME Test ID: 2021-01-18-15-1
Testing Lab: CT HQ - Sacramento Aggregate Testing Laboratory
Test Method: CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates
Test Release Date: 2021-05-14
Test Results

What size aggregate is being tested?: 1 in. x No. 4 - Coarse Aggregate
Individual or cumulative mass retained on each sieve?: Individual Mass Retained
Input Type: Measured
Tester's full name: Jay Horton
Date of test: 04/22/2021
Individual mass retained on the 1 1/2 in. sieve: 0 grams
Individual mass retained on the 1 in. sieve: 130.5 grams
Individual mass retained on the 3/4 in. sieve: 2164.7 grams
Individual mass retained on the 1/2 in. sieve: 4742 grams
Individual mass retained on the 3/8 in. sieve: 1463.1 grams
Individual mass retained on the #4 sieve: 2451.5 grams
Individual mass retained on the #8 sieve: 145 grams
Individual mass retained on the pan: 126.8 grams
Total mass of sample: 11224 grams
Cumulative percent passing the 1 1/2 in. sieve:100 %
Cumulative percent passing the 1 in. sieve:99 %
Cumulative percent passing the 3/4 in. sieve:80 %
Cumulative percent passing the 1/2 in. sieve:37 %
Cumulative percent passing the 3/8 in. sieve:24 %
Cumulative percent passing the #4 sieve:2 %
Cumulative percent passing the #8 sieve:1 %
General comments (publicly viewable) (Max 1000 characters): APP material is being shipped to your lab for QA testing. Please perform testing after receipt of material. Thank you, APP Administrator.

Test was verified on 05/14/2021