Test 2021-10-06-8-3 (CTM 227-December 2014) Summary

Project Information
Project IdentifiersProject ID: 214756
DEA: 050N7AU4
EFIS: 0520000030
DIST-CO-RTE-PM05-SB-101-1.4/4.8
Work DescriptionSegment 4A - Carpinteria: Construct HOV lanes and rehabilitation. Source inspection of sign structure trusses, lighting structures, epoxy coated rebar, precast box culverts, precast RCP.
Location DescriptionCARPINTERIA FROM 0.2 MILE SOUTH OF BAILARD AVENUE OVERCROSSING TO 0.7 MILE SOUTH OF SOUTH PADARO LANE
Sample Information
Sample Taken Date10/6/2021 Sample Unique Key8
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 testing10/6/2021
Sample typeQuality Control A brief description of the sample1" and sand
The quantity of what the sample constitutes2 bags From where was the sample collectedSource
First name of sampler or witnessed byTim Last name of sampler or witnessed byReyes
Title of sampler Laboratory sample identification
The fabricator/manufacturer/facility nameHanson - Goleta 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)91-42-0003
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 collectedconveyor belt
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design number63511N0P Lot number
Sublot number HMA Design ID
Test Details
DIME Sample ID: 2021-10-06-8
DIME Test ID: 2021-10-06-8-3
Testing Lab: Sequoia Consultant
Test Method: CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)
Test Release Date: 2021-10-07
Test Results

Describe the gradation of the aggregate or the test method:: All aggregate is the same size
Input Type: Calculated
Tester's full name: Tim Reyes
Date of test: 10/06/2021
Cleanness value (single primary size):75
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 10/07/2021