Summary for Test 2020-11-25-13-1

Test performed: CTM 213-December 2012

Project Information

Project IdentifiersProject ID: 215218
DEA: 043E6024
EFIS: 0414000084
DIST-CO-RTE-PM04-SF-101-6.7/8.1
Award Date11/20/2020
Closeout Date12/16/2021
Work DescriptionCOLD PLANE AC PAVEMENT AND PLACE RHMA-G AND HMA (TYPE A).
Location DescriptionTHE CITY AND COUNTY OF SAN FRANCISCO FROM VAN NESS AVENUE TO LYON STREET
QA Service Level1 (Verified on 10/26/2020)

Sample Information

Sample Taken Date11/25/2020 Sample Unique Key13
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 testing05/13/2021
Sample typeAnnual Source Testing A brief description of the sampleFine PCC Aggregate
The quantity of what the sample constitutes1 bags From where was the sample collectedSource
First name of sampler or witnessed byReza Last name of sampler or witnessed byDineli
Title of samplerMR Telephone number of sampler
Laboratory sample identification21-PCCC-0093 Linked DIME Sample ID
The fabricator/manufacturer/facility nameLos Banos TRP Transportation Laboratory (TL) NumberC934622
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)91-24-0009
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 collectednot provided
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: 2020-11-25-13
DIME Test ID: 2020-11-25-13-1
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: 2021-06-01

Test Results


Input Type: Measured
Tester's full name: Bang Nguyen
Date of test: 05/18/2021
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 6/1/2021