Summary for Test 2020-11-25-13-1
Test performed: CTM 213-December 2012Project Information
| Project Identifiers | Project ID: 215218 DEA: 043E6024 EFIS: 0414000084 |
|---|---|
| DIST-CO-RTE-PM | 04-SF-101-6.7/8.1 |
| Award Date | 11/20/2020 |
| Closeout Date | 12/16/2021 |
| Work Description | COLD PLANE AC PAVEMENT AND PLACE RHMA-G AND HMA (TYPE A). |
| Location Description | THE CITY AND COUNTY OF SAN FRANCISCO FROM VAN NESS AVENUE TO LYON STREET |
| QA Service Level | 1 (Verified on 10/26/2020) |
Sample Information
| Sample Taken Date | 11/25/2020 | Sample Unique Key | 13 |
|---|---|---|---|
| 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 | 05/13/2021 |
| Sample type | Annual Source Testing | A brief description of the sample | Fine PCC Aggregate |
| The quantity of what the sample constitutes | 1 bags | From where was the sample collected | Source |
| First name of sampler or witnessed by | Reza | Last name of sampler or witnessed by | Dineli |
| Title of sampler | MR | Telephone number of sampler | |
| Laboratory sample identification | 21-PCCC-0093 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Los Banos TRP | Transportation Laboratory (TL) Number | C934622 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 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 collected | not provided | |
| 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 |
Test Details
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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 ✔