Summary for Test 2014-11-13-3-1

Test performed: CTM 213-December 2012

Project Information

Project IdentifiersProject ID: 7463
DEA: 042640U4
EFIS: 0412000195
DIST-CO-RTE-PM04-SON-101-0.9/3.6
Award Date11/01/2012
Closeout Date06/03/2020
Work DescriptionCONSTRUCT PETALUMA BLVD SOUTH INTERCHANGE, REPLACE PETALUMA RIVER BR
Location DescriptionSONOMA COUNTY IN AND NEAR PETALUMA FROM GUNN DRIVE TO ROUTE 101/116 SEPARATION AND OVERHEAD
QA Service Level1 (Verified on 09/11/2012)

Sample Information

Sample Taken Date11/13/2014 Sample Unique Key3
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 testing01/23/2015
Sample typeAnnual Source Testing A brief description of the sampleConcrete Blend Sand
The quantity of what the sample constitutes1 From where was the sample collectedSource
First name of sampler or witnessed byQC Last name of sampler or witnessed byQC
Title of samplerQC Telephone number of samplerUnknown
Laboratory sample identification15FPCC-0049 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameSyar Lake Herman Transportation Laboratory (TL) NumberC917849
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)Syar Lake Herman
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 Quarry
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size
The concrete mix design number Lot numberNot set
Sublot numberNot set HMA Design ID

Test Details

DIME Sample ID: 2014-11-13-3
DIME Test ID: 2014-11-13-3-1
Testing Lab: CT HQ - Sacramento Aggregate Testing Laboratory
Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand
Test Release Date: 2015-01-29

Test Results


Input Type: Calculated
Tester's full name: Ed Perez
Date of test: 01/28/2015
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 1/29/2015