Test 2013-10-14-13302422-3 (CTM 213-December 2012) Summary

Project Information
Project IdentifiersProject ID: 208862
DEA: 080K7104
EFIS: 0800000366
DIST-CO-RTE-PM08-SBD-15,215-14.0/R16.4,16.0/17.8
Work DescriptionI-15/I-215 Interchange Improvements (Devore)
Location DescriptionOn I-15 from 0.8 mile south of Glen Helen Parkway UC to 1.4 mile north of Kenwood Ave UC And On I-215 from 1.2 mile south of Devore Road OC to the I-15 junction
Sample Information
Sample Taken Date10/14/2013 Sample Unique Key13302422
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 testing10/11/2013
Sample typeAnnual Source Testing A brief description of the sampleWashed Concrete Sand
The quantity of what the sample constitutes2 Bags From where was the sample collectedSource
First name of sampler or witnessed byUnknown Last name of sampler or witnessed byUnknown
Title of samplerNot set Laboratory sample identificationNot set
The fabricator/manufacturer/facility nameHolliday Upland 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 91-36-0003
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 Size
The concrete mix design number Lot numberNot set
Sublot numberNot set HMA Design ID
Test Details
DIME Sample ID: 2013-10-14-13302422
DIME Test ID: 2013-10-14-13302422-3
Testing Lab: CT - Southern Regional Laboratory
Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand
Test Release Date: 2015-02-20
Test Results

Input Type: Measured
Tester's full name: Satish Jain
Date of test: 10/14/2013
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 250 characters):

Test was verified on 02/20/2015