Summary for Test 2015-11-30-6-1

Test performed: CTM 213-December 2012

Project Information

Project IdentifiersProject ID: 7463
DEA: 042640U4
EFIS: 0412000195
DIST-CO-RTE-PM04-SON-101-0.9/3.6
Award Date11/02/2012
Closeout Date06/03/2020
Work DescriptionCONSTRUCT PETALUMA BLVD SOUTH INTERCHANGE, REPLACE PETALUMA RIVER BR
Location DescriptionSONOMA COUNTY IN AND NEAR PETALUMA FROM GUNN DRIVE TO ROUTE 101/116 SEPARATION AND OVERHEAD
QA Service Level1 (Verified on 09/11/2012)

Sample Information

Sample Taken Date11/30/2015 Sample Unique Key6
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 testing02/16/2016
Sample typeAnnual Source Testing A brief description of the sampleFine PCC Aggregate
The quantity of what the sample constitutes2 bags From where was the sample collectedSource
First name of sampler or witnessed byPlant Last name of sampler or witnessed byEmployee
Title of samplerQC Technician Telephone number of samplerUnknown
Laboratory sample identification16FPCC-0073 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameSyar Lake Herman Transportation Laboratory (TL) Numberc862737
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)91-48-0002::LAKE HERMAN QUARRY
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: 2015-11-30-6
DIME Test ID: 2015-11-30-6-1
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: 2016-03-14

Test Results


Input Type: Calculated
Tester's full name: Tom Stinnett
Date of test: 03/10/2016
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 3/14/2016