Test 2015-11-18-4-1 (CTM 213-December 2012) Summary

Project Information
Project IdentifiersProject ID: 210369
DEA: 042J2004
DIST-CO-RTE-PM04-SCL-152-30.4/35.2
Work DescriptionCOLD PLANE AC PAVEMENT AND PLACE RUBBERIZED HOT MIX ASPHALT.
Location DescriptionSANTA CLARA COUNTY 20 MILES EAST OF GILROY FROM PACHECO CREEK TO SANTA CLARA / MERCED COUNTY LINE
Sample Information
Sample Taken Date11/18/2015 Sample Unique Key4
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 testing1/21/2016
Sample typeAnnual Source Testing A brief description of the sampleFine PCC Aggregate
The quantity of what the sample constitutes3 bags From where was the sample collectedSource
First name of sampler or witnessed byCesar Last name of sampler or witnessed byRamirez
Title of samplerConsultant Laboratory sample identification16FPCC-0028
The fabricator/manufacturer/facility nameTriangle Rock Los Banos Transportation Laboratory (TL) NumberC931557
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierNot set
Structure nameNot set
Material Information
Material TypeAggregate Source Identification (SMARA or name of Pit)91-99-9999
The fabricator's/manufacturer's product name for the sampleUnknown The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedStockpile
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size
The concrete mix design number Lot numberNot set
Sublot numberNot set HMA Design ID
Test Details
DIME Sample ID: 2015-11-18-4
DIME Test ID: 2015-11-18-4-1
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: 2016-02-25
Test Results

Input Type: Calculated
Tester's full name: Tom Stinnett
Date of test: 01/28/2016
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 02/25/2016