Test 2013-10-30-11007779-3 (CTM 213-December 2012) Summary

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Project Information
Project IdentifiersProject ID: 7757
DEA: 07252614
EFIS: 0700021271
DIST-CO-RTE-PM07-LA-5-C43.9/C46.4
Work DescriptionREPLACE CONCRETE SLABS WITH PRECAST CONCRETE PANELS.
Location DescriptionLOS ANGELES COUNTY IN AND NEAR LOS ANGELES FROM SAN FERNANDO ROAD OVERHEAD TO 0.2 MILE SOUTH OF WELDON CANYON OVERCROSSING
Sample Information
Sample Taken Date10/30/2013 Sample Unique Key11007779
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 testing10/31/2013
Sample typeAnnual Source Testing A brief description of the sampleWashed Concrete Sand
The quantity of what the sample constitutes 3 Bags From where was the sample collectedSource
First name of sampler or witnessed byJeff Last name of sampler or witnessed byLopez
Title of samplerQuality Control Manager Laboratory sample identification3261B
The fabricator/manufacturer/facility nameCemex Lytle Creek 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. 91-36-0040
The fabricator's/manufacturer's product name for the sampleNot set The fabricator/manufacturer designation for the sampleNot set
The plant numberNot set A detailed description of where the material sample was collectedConveyer Belt
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: 2013-10-30-11007779
DIME Test ID: 2013-10-30-11007779-3
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: Calculated
Tester's full name: Nader Rashidi
Date of test: 11/07/2013
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 02/28/2014