Summary for Test 2013-10-30-11007779-3

Test performed: CTM 213-December 2012

Project Information

Project IdentifiersProject ID: 7757
DEA: 07252614
EFIS: 0700021271
DIST-CO-RTE-PM07-LA-5-C43.9/C46.4
Award Date12/12/2012
Closeout Date06/02/2015
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
QA Service Level1 (Verified on 11/12/2012)

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 Telephone number of sampler(951) 634-2002
Laboratory sample identification3261B Linked DIME Sample IDNot set
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)91-36-0040::LYTLE CREEK
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 2/28/2014