Test 2015-12-24-1-1 (CTM 213-December 2012) Summary

Project Information
Project IdentifiersProject ID: 209135
DEA: 04235844
EFIS: 0400000684
COOP: 042493
DIST-CO-RTE-PM04-SM-101-16.3/17.06
Work DescriptionRECONSTRUCT OVERCROSSING, RETAINING WALLS, GROUND IMPROVEMENT,
Location DescriptionBURLINGAME
Sample Information
Sample Taken Date12/24/2015 Sample Unique Key1
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 testing2/5/2016
Sample typeAnnual Source Testing A brief description of the sampleFine PCC Aggregate
The quantity of what the sample constitutes1 bag From where was the sample collectedSource
First name of sampler or witnessed byPlant Last name of sampler or witnessed byEmployee
Title of samplerUnknown Laboratory sample identification16FPCC-0064
The fabricator/manufacturer/facility nameWilson Quarry Aromas Transportation Laboratory (TL) Numberc910807
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)91-35-0012
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: 2015-12-24-1
DIME Test ID: 2015-12-24-1-1
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: 2016-03-04
Test Results

Input Type: Calculated
Tester's full name: Tom Stinnett
Date of test: 02/23/2016
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 03/04/2016