Test 2019-10-14-20-3 (CTM 227-December 2014) Summary

Project Information
Project IdentifiersProject ID: 66666
DEA: APP
EFIS: 0019000052
DIST-CO-RTE-PM59---
Work DescriptionSpecial project for submitting Sample information for Aggregate Pre-approval Program (APP). Object Code: 1025. J2 DEA: 912680.
Location DescriptionNot set
Sample Information
Sample Taken Date10/14/2019 Sample Unique Key20
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 testing10/15/2019
Sample typeAggregate Prequalification Program A brief description of the sample1 X 4 CA
The quantity of what the sample constitutesproduction stockpile. From where was the sample collectedManufacturer
First name of sampler or witnessed byJonathon Last name of sampler or witnessed byBlumer
Title of samplerLab Technician Laboratory sample identification
The fabricator/manufacturer/facility nameTeichert Materials Woodland Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name
Material Information
Material TypeAggregate Source Identification (SMARA or name of Pit)91-57-0002::WOODLAND PLANT
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 @ Plant
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size1 inch
The concrete mix design numberUnknown Lot numberUnknown
Sublot numberUnknown HMA Design ID
Test Details
DIME Sample ID: 2019-10-14-20
DIME Test ID: 2019-10-14-20-3
Testing Lab: Teichert Materials - Sacramento
Test Method: CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)
Test Release Date: 2019-10-22
Test Results

Describe the gradation of the aggregate or the test method:: Mix of sizes - max 1.5 in.
Input Type: Calculated
Tester's full name: Eric Gifford
Date of test: 10/22/2019
Cleanness value (11/2 in. maximum aggregate mix):88
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 10/22/2019