Test 2020-11-25-13-1 (CTM 213-December 2012) Summary

Project Information
Project IdentifiersProject ID: 215218
DEA: 043E6024
EFIS: 0414000084
DIST-CO-RTE-PM04-SF-101-6.7/8.1
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
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 testing5/13/2021
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 Laboratory sample identification21-PCCC-0093
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 06/01/2021