Test 2013-09-16-9101-3 (CTM 213-December 2012) Summary

Project Information
Project IdentifiersProject ID: 208944
DEA: 07187224
EFIS: 0700000189
DIST-CO-RTE-PM07-LA-126-R6.8/R9.2
Work DescriptionSR 126/Commerce Center Drive Interchange Project
Location DescriptionNorthwest of the City of Santa Clarita in unincorporated Los Angeles County
Sample Information
Sample Taken Date9/16/2013 Sample Unique Key9101
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 testing9/17/2013
Sample typeAnnual Source Testing A brief description of the sampleWashed Concrete Sand
The quantity of what the sample constitutes3 Bags From where was the sample collectedSource
First name of sampler or witnessed byKevin Last name of sampler or witnessed byHopkins
Title of samplerMREA Laboratory sample identification3241B
The fabricator/manufacturer/facility nameHolliday Palmdale Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set
Material Information
Material TypeAggregate Source Identification (SMARA or name of Pit)SMARA No. 91-19-0001
The fabricator's/manufacturer's product name for the sampleWashed Concrete Sand The fabricator/manufacturer designation for the sampleNot set
The plant numberNot set A detailed description of where the material sample was collectedStockpile
Where the material sample would have been placed if not sampledNot set Primary Aggregate Nominal Sizefine
The concrete mix design number Lot numberNot set
Sublot numberNot set HMA Design ID
Test Details
DIME Sample ID: 2013-09-16-9101
DIME Test ID: 2013-09-16-9101-3
Testing Lab: CT - Southern Regional Laboratory
Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand
Test Release Date: 2014-02-28
Test Results

Input Type: Measured
Tester's full name: Satish Jain
Date of test: 09/18/2013
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 250 characters):

Test was verified on 02/28/2014